Sanad M M, Darwish R A, Nasr M E, el-Gammal N E, Emara M W
Department of Parasitology, Faculty of Medicine, Zagazig University, Egypt.
J Egypt Soc Parasitol. 1996 Aug;26(2):481-95.
One hundred and two patients suffering from giardiasis and/or chronic gastritis were subjected for upper gastrointestinal endoscopy. Purified immune rabbit's serum against Giardia lamblia was used in ELISA and immunoperoxidase (IIP) techniques for detection of Giardia antigen in the stomach. Results showed that out of 70 cases with intestinal giardiasis, 8 (11.4%) by ELISA and 6 (8.6%) by IIP showed gastric giardiasis. Higher percentage of gastric giardiasis (14%) was encountered in cases with both giardiasis and chronic gastritis (50) than in cases with giardiasis alone (5%) but with statistically insignificant difference (P > 0.05). None of the cases with chronic gastritis alone (without giardiasis) was positive for gastric giardiasis. Dyspepsia was the main presenting symptom in cases with gastric giardiasis (P < 0.05) with significant (P < 0.05) association. Helicobacter pylori was encountered in 6 out of 8 cases (75%) with gastric giardiasis (P < 0.05) with significant (P < 0.05) association. Duodenogastric reflux was detected in 4 out of 8 cases (50%). Histopathological changes in antral mucosa were detected in all cases of gastric giardiasis. This study indicates that under abnormal circumstances most probably with decreased gastric acidity, gastric giardiasis can occur in concomitance with intestinal giardiasis. So, one has to search for Giardia in gastric biopsies, particularly those showing chronic atrophic gastritis and H. pylori. Also, one has to be aware of gastric giardiasis as a possible cause of upper gastrointestinal symptoms.
102例患有贾第虫病和/或慢性胃炎的患者接受了上消化道内镜检查。采用抗蓝氏贾第鞭毛虫的纯化免疫兔血清，通过酶联免疫吸附测定（ELISA）和免疫过氧化物酶（IIP）技术检测胃内的贾第虫抗原。结果显示，在70例肠道贾第虫病患者中，ELISA检测出8例（11.4%）胃内有贾第虫病，IIP检测出6例（8.6%）。同时患有贾第虫病和慢性胃炎的50例患者中，胃内贾第虫病的比例更高（14%），高于单纯贾第虫病患者（5%），但差异无统计学意义（P>0.05）。单纯慢性胃炎（无贾第虫病）患者中，无胃内贾第虫病阳性病例。消化不良是胃内贾第虫病患者的主要症状（P<0.05），二者有显著相关性（P<0.05）。8例胃内贾第虫病患者中有6例（75%）检测出幽门螺杆菌（P<0.05），二者有显著相关性（P<0.05）。8例中有4例（50%）检测出十二指肠胃反流。所有胃内贾第虫病病例均检测出胃窦黏膜的组织病理学改变。本研究表明，在异常情况下，很可能是胃酸降低时，胃内贾第虫病可与肠道贾第虫病同时发生。因此，必须在胃活检组织中查找贾第虫，尤其是那些显示慢性萎缩性胃炎和幽门螺杆菌感染的组织。此外，必须意识到胃内贾第虫病可能是上消化道症状的一个原因。
