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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In northeastern Australia, the incidence of human eosinophilic enteritis (EE) and unexplained abdominal pain with peripheral blood eosinophilia (PE) appear to be exceptionally high. Because adults of the common dog hookworm, Ancylostoma caninum, were found in situ in several cases, we compared specific antibody responses in patients with EE or PE with those of individuals from various control groups. Sera were obtained from three patients with confirmed dog hookworm infection, 25 patients with EE/PE, 42 with other diagnosed gastrointestinal disorders, eight with human hookworm infection, 27 with other diagnosed parasitic infections, and 100 blood donors from the State of Tasmania, where A. caninum does not occur. They were analyzed by enzyme-linked immunosorbent assay (ELISA) and Western blot for IgG and IgE antibodies to excretory-secretory (ES) antigens from adult A. caninum. In the ELISA, sera from 88% of EE/PE patients were positive for IgG and IgE antibodies to ES antigen. All eight patients infected with human hookworm (identified as A. duodenale in three) were also seropositive, while most of those with other parasitic infections, as well the blood donors, those with diagnosed gastrointestinal diseases, and the control subjects, were seronegative. In Western blots, sera from 92% of EE/PE patients demonstrated IgG and IgE antibodies to a component of ES antigen with a molecular weight of approximately 68 kD (Ac68), as did all sera from cases infected with human hookworms. Among the patients with other gastrointestinal disorders and parasitic infections, four of 42 (10%) and three of 27 (11%), respectively, reacted positively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Immunologic incrimination of Ancylostoma caninum as a human enteric pathogen. 830 75

Most patients with proven or suspected enteric infection with the common hookworm of dogs, Ancylostoma caninum, produce immunoglobulin G (IgG) and IgE antibodies to an immunodominant excretory/secretory antigen (Ac68) of the parasite. These antibodies were detected in both enzyme-linked immunosorbent assay (ELISA) and Western blots; the Western blot to detect IgG antibodies to Ac68 was the most specific and sensitive. The subclasses of IgG of the antibody response to the parasite were analyzed using Western blots with anti-IgG subclass-specific monoclonal antibodies as marker systems in an attempt to further improve the specificity of the assay. Eight patients with confirmed enteric infections with A. caninum (positive controls) were tested; six had antibodies in all IgG subclasses against Ac68. Twenty sera from patients with suspected enteric infection with A. caninum (manifested as eosinophilic enteritis or unexplained abdominal pain with peripheral eosinophilia) were tested; 16 had total IgG antibodies to Ac68, while IgG1, IgG2, IgG3, and IgG4 responses were found in 11, 10, 9, and 12 of these sera, respectively. Small numbers of sera from groups of patients infected with other helminths and from healthy blood donors had various combinations of IgG, IgG1, IgG2, and IgG3 antibodies to Ac68, but none of these sera had IgG4 antibodies to Ac68. Sera from all nine patients with human hookworm infection had IgG, IgG1, IgG2, and IgG3 antibodies to Ac68 and eight of the nine were also positive for IgG4 antibodies. These results indicate the Western blot to detect IgG4 antibodies to Ac68 is the most reliable immunodiagnostic test yet described for enteric infection with A. caninum, although this test does not discriminate between infections with human and canine hookworms.
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PMID:Immunoglobulin G subclass antibodies against excretory/secretory antigens of Ancylostoma caninum in human enteric infections. 868 91

A study was conducted in the city of Lubumbashi, Zaire: (1) to survey parasitic infections and clinical conditions in the local children and their mothers; (2) to identify combinations of parasites and clinical conditions that commonly occurred together in individuals; and (3) to determine whether single- and/or multiple-species infections were risk determinants of the observed clinical conditions. Overall, 1100 children and mothers from three subdivisions, two of low socio-economic status (LSES) and one of relatively high socio-economic status (HSES), provided stool and blood samples and were clinically examined. Plasmodium prevalence was higher in the two LSES subdivisions than in the HSES subdivision. Prevalence and intensity of Ascaris lumbricoides infection were low in the HSES subdivision and one of the two LSES subdivisions. In contrast, prevalence and intensity of Trichuris trichiura and of hookworms were similar in all subdivisions. Plasmodium and A. lumbricoides were the most frequently found single-species infections. The combination of A. lumbricoides and Plasmodium was the most frequent double-species infection and that of A. lumbricoides, Plasmodium and T. trichiura was the most frequent triple-species infection. Significant positive associations between parasite species were detected in the HSES subdivision, and in one of the two LSES subdivisions. Because the relationships were not consistently detected, it is hypothesized that the associations are determined by environmental conditions rather than synergy between the parasites in the host. The most commonly observed clinical conditions were abdominal pain, diarrhoea, fever, and low packed-cell volume (PCV). The occurrence of each was significantly lower in the HSES subdivision than in at least one of the two LSES subdivisions. Abdominal pain and low PCV were most common in individuals presenting with only a single clinical condition, and the combination of this symptom and sign was the most commonly observed pair of conditions. Abdominal pain, low PCV and diarrhoea was the most common combination in individuals with three clinical conditions. Logistic regression revealed that hookworm infection, T. trichiura infection, young age and residence in an LSES subdivision were determinants of diarrhoea. Trichuris trichiura infection, young age and living in an LSES subdivision were risk factors for abdominal pain. Plasmodium infection and young age were risk factors for fever. LSES was the only predictor of low PCV. Infection with A. lumbricoides did not enter any of the models. No significant interactions were detected among parasites, indicating that there was no synergism or antagonism among parasites in the induced disease.
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PMID:Multiple infection with Plasmodium and helminths in communities of low and relatively high socio-economic status. 875 42

Till date only three series of immunoproliferative small intestinal disease (IPSID) describing 22 patients have been reported from India. Seven patients with IPSID in two tertiary referral centers in India are included in the study. Diagnosis was based on typical clinical features [diarrhoea (7/7), weight loss (7/7), clubbing (6/7), fever (3/7), abdominal pain and lump (3/7)], biochemical evidence of malabsorption and duodenal biopsy findings. All patients were young males (mean age 29.8 +/- 11.8 years, range 17-53). Atypical features included gastric involvement (1/7), colonic involvement (1/7) and appearance of pigmented nails following anti-cancer chemotherapy (1/7) which disappeared six months after omitting doxorubin from chemotherapy regimen. Parasitic infestation was common. Ascaris lumbricoides (1/7), Giardia lamblia and hookworm (1/7), Strongyloides stercoralis and Trichuris trichura (1/7). In the latter patient S. stercoralis became disseminated after anti-malignant chemotherapy. One patient had gastric H. pylori infection. Four of the seven patients who were misdiagnosed as tropical sprue were treated with tetracycline. This raises doubt on efficacy of tetracycline alone in treatment of IPSID. One other patient was misdiagnosed and treated as intestinal tuberculosis. Early diagnosis and administration of chemotherapy may improve survival in this disease.
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PMID:Is immunoproliferative small intestinal disease uncommon in India? 1139 37

Ancylostoma caninum is responsible for cases with eosinophilic enteritis (EE) and unexplained abdominal pain with peripheral eosinophilia in man. Ninety-five patients with obscure acute or recurrent abdominal pain and ten asymptomatic healthy parasite free were subjected to thorough history taking, clinical examination, sonography, routine laboratory investigations and serotesting by IgG ELISA to detect antibodies to excretory/secretory (ES) antigens of adult A. caninum and by IgG and IgG4 Western blot (W.B.) to detect antibodies to Ac68 antigen. Eleven male patients (11.6%) (5 with acute abdomen, 3 diagnosed as appendicitis and 3 had recurrent mild to moderate abdominal pain) fulfilled the criteria of case definition of human enteric infection with A. caninum (G.I). The study also detected human hookworm infection in 14 patients (G.IIb) other parasites in 34 patients (GIIc) and 36 patients had no parasites (G.IIa). Although 3 patients from group I were diagnosed as appendicitis and were dealt with surgically, the pain recurred and mebendazole only put an end to the patient's complaints. The obtained appendices of these operated cases showed marked eosinophilic infiltration but no adult canine hookworms were detected. IgG ELISA was positive in 72.7%, 8.3%, 100%, 23.5% and 0% in groups and control respectively. IgG and IgG4 W.B. did not increase the sensitivity but IgG4 W.B. elevated specificity to 100% excluding those with HH infection (Group Iib) who showed 100% cross-reactions. Stool analysis was the only differentiation between these two types of hookworms. These findings confirmed the presence of human enteric infection with A. caninum as clinical entity in the study community and referred to its value in differential diagnosis of the obscure abdominal pain.
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PMID:Evaluation of the role of Ancylostoma caninum in humans as a cause of acute and recurrent abdominal pain. 1256 26

Helminths or worm infestations refer to worms that live as parasites in the human body and are a fundamental cause of disease associated with health and nutrition problems beyond gastrointestinal tract disturbances. Globally, over 3.5 billion people are infected with intestinal worms, of which 1.47 billion are with roundworm, 1.3 billion people with hookworm and 1.05 billion with whipworm. School children aged 5 - 15 years suffer the highest infection rate and worm burden that attributes to poor sanitation and hygiene. About 400 million school-age children are infected with roundworm, whipworm and hookworm worldwide, a large proportion of whom are found in the East Asia region (Cambodia, China, Lao PDR, Thailand and Vietnam). These parasites consume nutrients from children they infect, thus retarding their physical development. They destroy tissues and organs, cause abdominal pain, diarrhoea, intestinal obstruction, anaemia, ulcers and other health problems. All of these consequences of infection can slow cognitive development and thus impair learning. De-worming school children by anthelmintic drug treatment is a curative approach for expelling the heavy worm load. However, drug therapy alone is only a short-term measure of reducing worm infection and re-infection is frequent. Control measures through improved sanitation, hygiene and de-worming are needed to prevent infection and re-infection. UNICEF has supported many governments in this (and other) regions to assist in the provision of water supply and sanitary facilities and intensive hygiene education in many schools through the Water, Environment and Sanitation (WES) programme. The UNICEF supported school sanitation and hygiene education (SSHE) programme, and other programmes, could effectively enhance behaviour change in children to break the routes of worm transmission and other waterborne diseases.
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PMID:De-worming school children and hygiene intervention. 1277 91

A prospective study of the stool samples of 129 rural patients with symptoms of upper abdominal pain, tenderness and indigestion was carried out from 2 February 1998 to 31 December 1998 and followed up to June 1999. The age range was 11-85 years, female:male ratio 2.4:1: 102 specimens were positive for helminths--Ancylostoma duodenale (hookworm) 80 (62%); Trichuris trichuria (threadworm) 12 (9.3%); Ascaris lumbricoides (large roundworm) 10 (7.76%); Strongyloides stercoralis three (2.3%); Taenia saginata (tapeworm) three (2.3%). The female:male ratio for hookworm was 3:1. Treatment with appropriate anthelminthic agents were given serially at each visit according to the result of faecal examination. At 6 months follow up 88 patients were free of symptoms, 60 of which were caused by helminths the hookworm group. Stool 'test and treat' strategy appears to be a cost-effective approach in the management of these patients.
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PMID:Reducing burden of hookworm disease in the management of upper abdominal pain in the tropics. 1287 Jun 11

A single dose of Tetramisole, 2.5 mg/kg body weight, was given to the infected cases of intestinal parasites. The number of cases were: Ascaris lumbriocides 96, hookworm 16, Trichostrongylus orientalis 10, Trichocephalus trichiurus 114 and Clonorchis sinensis 19. No dietary restriction before and after the administration of Tetramisole was required. 1. In Ascaris infection the egg negative conversion rate and the egg reduction rate were 92.7 per cent and 99.5 per cent, respectively. 2. In Trichostrongylus orientalis infections, 9 out of 10 cases were resulted egg negative after the single dose of Tetramisole, and hookworm, 12 out of 16 administered showed egg negative. However, there were no appreciable effectiveness to the cases of Trichocephalus trichiurus and Clonorchis sinensis. 3. Mild and transient side effects were noted in 75 cases (54.5%) out of 140 cases. The main symptoms were dizziness (25.5%), anorexia (25.5%), abdominal pain (18.6%), diarrhea (16.6%), headache (15.2%), nausea (14.4%) and fever (11.0%). From the above results, it is anticipated that Tetramisole is an effective anthelminthic for elimination of Ascaris, Trichostrongylus and hookworm.
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PMID:[Anthelminthic Effectiveness Of 2,3,5,6-Tetrahydro 6-Phenyl-Imidazole (2,1-B) Thiazole Hydrochloride (=tetramisole) Upon Intestinal Parasites] 1291 13

Hookworm infection and peptic ulcer disease are common in subtropical and tropical countries. While hookworm infection is endemic where sanitary conditions are poor, peptic ulcer disease is associated with a high prevalence of Helicobacter pylori infection. Dyspepsia and epigastric pain are common presenting symptoms of patients with either hookworm infection or peptic ulcer disease. Consequently it is common practice at our healthcare facility to examine stool for ova or parasites before considering empirical gastric acid suppressive therapy or Helicobacter pylori eradication therapy. We describe a patient who presented with dyspepsia and epigastric pain whose stool examination showed no ova or parasites. The patient's symptoms did not improve with proton pump inhibitor therapy. Endoscopy revealed hookworms in the first part of the duodenum. We review published reports of hookworms at this location. In hookworm endemic areas, when empirical treatment for dyspepsia and upper abdominal pain with acid suppressive agents does not offer remedy, antihelminthic agents should be considered even when stool for ova or parasites is negative.
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PMID:Hookworm infection of the duodenum associated with dyspepsia and diagnosed by oesophagoduodenoscopy: case report. 1768 16

In June 2006, 118 Singaporean soldiers visited Brunei for jungle training for 10 days. Subsequently, two soldiers had severe diarrhoea and were diagnosed with severe hookworm infection. An epidemiological investigation and case-control study was conducted among the 118 soldiers. A survey was administered to determine the exposures predisposing to infection. Laboratory tests included a full blood count and three separate faecal screens via microscopy and culture. All servicemen were treated with one dose of mebendazole, and follow-up screening was performed 3 months later. Of 113 soldiers completing the questionnaire, 43 soldiers (38%) reported gastrointestinal symptoms post deployment, with 33 (29%) complaining of diarrhoea and 29 (26%) of abdominal pain. Eight had an itch or rash, but none were suggestive of cutaneous larva migrans. Of 103 soldiers completing both the questionnaire and with all the laboratory tests, 42 soldiers (41%) had eosinophilia (>0.6x10(9)/l) and 18 (17%) had hookworm infection on microscopy. More than 89% recalled substantial exposure to soil or groundwater, but no exposure was significantly associated with eosinophilia or infection. After adjusting for possible exposures, not wearing footwear during rest periods had a significantly higher odds ratio (2.86) for acquiring hookworm infection or eosinophilia. Helminth infections are common in visitors to rural Asia. As preventing exposure is often difficult, empirical treatment with anthelminthics should be considered in travellers to high risk areas.
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PMID:Hookworm infections in Singaporean soldiers after jungle training in Brunei Darussalam. 1791 71


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