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[内脏和眼部幼虫移行症:20例成人及儿童的流行病学研究、临床及免疫学发现]

[Visceral and ocular Larva migrans: epidemiologic study, clinical and immunologic findings on 20 cases, adult and child].

作者信息

Scaglia M, Gatti S, Bruno A, Cevini C, Chichino G, Magnani B, Brustia R

机构信息

Département de Maladies Infectieuses, Université de Pavia-IRCCS S. Matteo, Italie.

出版信息

Bull Soc Pathol Exot Filiales. 1989;82(3):410-21.

PMID:2766448
Abstract

The authors report a case-study of 20 subjects affected by visceral Larva migrans (VLM) and ocular Larva migrans (OLM). Of the 20 patients, 11 were male, and 9 female (mean age: 45 years); 7 were children, from 1 to 8 years old. Seventeen patients presented clinical and bio-humoral features which could be correlated with VLM syndrome; alongside cases with clearly suggestive symptomatology, in some patients the infection by Toxocara sp. was found to show few or minor symptoms, or even to be asymptomatic and occasionally it was suspected because of a marked peripheral eosinophilia. In 3 cases the infection was exclusively ocular. So far as immunology is concerned, serological tests confirmed in all 20 cases the clinico-epidemiological and/or bio-humoral suspicion; in particular the ELISA IgG test showed high titres in 16 cases, while the RAST showed significant levels of specific IgE in 17 cases. From the therapeutic point of view, the subjects treated were exclusively those presenting a manifest clinical picture: in 5 patients the first choice drug was thiabendazole, with clinical cure in only 2 cases; diethylcarbamazine resolved the clinico-parasitological picture in 1 case; 1 patient is still under treatment with albendazole.

摘要

作者报告了一项针对20例内脏幼虫移行症(VLM)和眼幼虫移行症(OLM)患者的病例研究。20例患者中,11例为男性,9例为女性(平均年龄:45岁);7例为儿童,年龄在1至8岁之间。17例患者表现出与VLM综合征相关的临床和生物体液特征;除了具有明显提示性症状的病例外,在一些患者中发现,弓蛔虫属感染表现出很少或轻微的症状,甚至无症状,偶尔因明显的外周嗜酸性粒细胞增多而被怀疑。3例感染仅累及眼部。就免疫学而言,血清学检测在所有20例病例中均证实了临床流行病学和/或生物体液方面的怀疑;特别是ELISA IgG检测在16例中显示出高滴度,而RAST在17例中显示出显著水平的特异性IgE。从治疗角度来看,接受治疗的仅为那些呈现明显临床症状的患者:5例患者首选药物为噻苯达唑,仅2例临床治愈;乙胺嗪使1例患者的临床寄生虫学症状得到缓解;1例患者仍在接受阿苯达唑治疗。

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