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Query: UMLS:C0017536 (giardiasis)
 1,714 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Giardiasis has been reported increasingly among visitors to the Soviet Union and is found at epidemic and endemic levels in the United States. The main source of infection is contaminated water. Children, homosexual males, and patients with gastrectomy, achlorhydria, hypogammaglobulinemia, secretory IgA deficiency, or alteration in immune status are particularly susceptible to severe, often chronic, infection. Symptomatic giardiasis can be acute, subacute, or chronic. Symptoms are explosive, watery, foul-smelling stools or semisolid stools with evidence of steatorrhea; flatulence; abdominal distention; and weight loss. Diagnosis usually can be established by examination of stool or duodenal fluid for cysts or trophozoites. Quinacrine hydrochloride is the drug preferred for treatment, but metronidazole and furazolidone are also useful.
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PMID:Giardiasis: a common cause of diarrheal disease. 49 84

Nodular lymphoid hyperplasia (NLH) has been firmly associated with syndromes of hypogammaglobulinemia but not with selective absence of IgA. We report the case of a 5-yr-old girl with the triad of selective IgA deficiency, NLH of the small bowel, and giardiasis. Results of an extensive immunologic investigation, including immunohistochemical examinations of small bowel biopsies, support the hypothesis that the basic defect responsible for IgA deficiency in this patient was the failure of precursor IgM-bearing lymphocytes to differentiate into IgA-producing plasma cells. Furthermore, the abundance of IgM-bearing cells in biopsy specimens demonstrates the existence of a compensatory mechanism in the intestine to substitute IgM for the absent IgA.
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PMID:Selective immunoglobulin A deficiency associated with modular lymphoid hyperplasia. 51 69

We had a patient with primary acquired hypogammaglobulinemia (PAH), nodular lymphoid hyperplasia, giardiasis, and the subsequent development of regional enteritis (RE). The case is of interest because the development of regional enteritis in a patient with PAH has not been previously reported, to our knowledge. The interaction of hypogammaglobulinemia and RE is discussed from an immunologic point of view. The report adds RE to the many known bowel diseases associated with PAH.
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PMID:Primary acquired hypogammaglobulinemia and regional enteritis. 90 Oct 97

Giardia lamblia infestation can cause severe diarrhea and malabsorption, and the diagnosis is usually made by identification of cysts in the feces, but small intestinal biopsy or smears may be required. A wide spectrum of roentgen changes may be seen. In patients with a normal immune status, the small bowel is normal or shows an inflammatory bowel disease pattern. Eradication of the parasite reverses these changes. In some patients with IgA deficiency, nodular lymphoid hyperplasia occurs, and this is usually not reversible. Other patients with hypogammaglobulinemia or dysgammaglobulinemia and giardiasis may show a sprue pattern. This pattern most often persists after eradication of the parasite. Although the triad of giardiasis, IgA deficiency, and nodular lymphoid hyperplasia has a particularly high association, these, together with diarrhea, malabsorption, and various altered immune states may occur in any combination.
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PMID:Current perspectives on giardiasis. 110 21

A novelty of the present studies is the use of alpha 1-antitrypsin (A-1--AT) as an endogenous marker of enteric protein loss. Enteric clearance of alpha 1-antitrypsin was determined in 10 patients with the symptoms of PLE, and in 6 healthy individuals. Alpha 1-Antitrypsin concentration has been assayed in single, random samples of feces collected from 42 patients and 12 healthy individuals (normal values: 1.31 +/- 0.72 mg/g of feces). Markedly increased enteric clearance and A-1-AT concentrations in single, random samples of feces have been found in patients with enteric lymphangiectasis, Crohn's disease, ulcerative colitis, and constrictive pericarditis, slightly lower in coeliac, chronic diarrhoea, nonspecific hemorrhagic colitis, esophagitis, lambliasis, hypogammaglobulinemia, Wiskott-Aldrich syndrome, Rendu-Osler-Weber syndrome, hepatitis in newborn, and Gilbert's disease. Statistically significant positive clearance has been noted (r = 0.997; p less than .001). A single assay of A-1-AT in feces is simple, repeatable, and sensitive technique in the diagnosis and evaluation of these diseases in which the symptoms of enteric protein loss are seen.
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PMID:[Alpha 1-antitrypsin as an endogenous marker of protein-losing enteropathies]. 143 95

Fifteen cases of nodular lymphoid hyperplasia (NLH) of the bowel in patients aged 17 months to 15 years are reported. Fourteen patients had NLH confined to the small bowel and one had involvement of both the small bowel and colon. Mean age at diagnosis was 10 years. The most common presenting symptoms were intestinal manifestations (86%). Diagnosis was suspected upon roentgenographic studies in one case and digestive endoscopy in ten cases. Histologic confirmation was obtained in all fifteen patients. Immunohistochemical studies, done in 8 patients, demonstrated a paucity of IgA plasmocytes in one patient with an immune deficiency and a polyclonal plasmocyte population with mainly IgA plasmocytes in the seven other patients. Five patients had a deficiency in humoral immunity, with variable expression hypogammaglobulinemia in three patients and IgA deficiency in two; intestinal giardiasis was found in eight patients. Histologic outcome was documented in five cases; evidence of NLH disappeared in only one patient. Metronidazole improved clinical symptoms in most instances.
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PMID:[Lymphoid hyperplasia of the intestine in children. 15 cases]. 149 85

We describe a patient with severe common variable hypogammaglobulinemia (CVH) whose clinical course was dominated by resistant giardiasis requiring prolonged hospitalization. The giardiasis was eventually controlled by initial metronidazole and subsequent mepacrine therapy, but side effects necessitated the withdrawal of both of these drugs. Replacement immunoglobulin treatment failed to restore normal serum immunoglobulin levels, but despite this, they appeared to be of value in reducing the liability to recurrent giardiasis. We discuss the use of immunoglobulin supplementation in this condition and the frequent association between CVH and pentagastrinfast achlorhydria.
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PMID:Common variable hypogammaglobulinemia. A case report. 236 6

A patient with common variable hypogammaglobulinemia (CVH) who presented with recurrent sinopulmonary infections, nodular lymphoid hyperplasia of the small bowel, and intestinal giardiasis was studied. A diffuse lymphocytic lymphoma with small bowel, skin, and hepatic involvement subsequently developed in the patient. Light microscopy of the tumor revealed tissue infiltration with mononuclear cells having the morphologic features of T-lymphocytes. The malignant lymphocytes had characteristics of T-suppressor/cytotoxic cells as established by the absence of surface immunoglobulin and Leu 3 surface markers, and the presence of OKT3 and OKT8 surface markers. Peripheral blood lymphocyte studies revealed an increased number of T-suppressor cells, a reversal of the helper-suppressor ratio, and a generalized state of hyporesponsiveness to mitogen and antigen stimulation. No evidence of retroviral reverse transcriptase activity was detected in cultures of peripheral blood lymphocytes. The association between CVH and a lymphoma composed of cells with T-suppressor/cytotoxic surface markers has not been previously reported. The postulated role of T-suppressor cells in the failure of immunoglobulin synthesis in some forms of CVH suggests that the finding of a T-suppressor/cytotoxic cell lymphoma complicating CVH may be more than fortuitous.
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PMID:Common variable hypogammaglobulinemia complicated by an unusual T-suppressor/cytotoxic cell lymphoma. 294 34

In this review I have examined the vast literature which has accumulated on Cryptosporidium, particularly in the past 3 years, in an attempt to highlight areas in which progress has been made in relation to the organism and the disease, and to indicate areas in which knowledge is still lacking. Since 1982, a global effort by scientists and clinicians has been directed towards determining the nature of the disease in humans and the relative contribution of cryptosporidiosis to gastroenteritis. From published data, the incidence of diarrhoea is 1-5% in most developed countries, and 4-7% in less developed countries, when measured throughout the year and in all age groups. The frequency of cryptosporidiosis is highest in children aged between 6 months and 3 years, and in particular locations (e.g., day-care centres) and at particular times of the year. Although susceptibility to infection is life-long, one suspects that the lower prevalence among older children and adults is due to immunity acquired from frequent exposure. Other important factors contributing to higher prevalence are the season--it is more frequent in a wet, warm climate--association with travel to particular destinations, poor hygiene, intimate contact with certain animals, and congregation of large numbers of young previously unexposed children in day-care centres. The association between cryptosporidiosis and giardiasis presumably results from the existence of a common source of infection. The immune status of the host appears to be a major determinant of whether the infection is self-limiting or persistent. It is clear that both branches of the immune system are required for complete recovery, since T-lymphocyte dysfunction or hypogammaglobulinaemia can both lead to persistent illness. Chronic diarrhoea and malabsorption attributed to cryptosporidiosis also occur in the absence of evidence of immune defect. The importance of respiratory tract infection in humans, other than in the terminal stages of chronic illness, requires investigation. The infection has now been identified in all classes of vertebrates; it has been observed in all domestic animals including pets, and a wide range of wildlife including birds. Cryptosporidiosis seems to cause diarrhoea in young ruminants, less frequently in pets. In birds the parasite has been observed in the gastrointestinal tract, without ill effect, and in the respiratory tract, in which clinical symptoms of variable severity have been described. The mucosal response of the gastrointestinal tract to infection appears to vary among mammals and may be the key to the variable clinical manifestations observed.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Cryptosporidiosis in perspective. 328 31

The phagocytic, bactericidal, and metabolic capabilities of circulating blood leukocytes from three adults (two males, one female) with hypogammaglobulinemia and recurrent pneumonia, chronic sinusitis, and intestinal giardiasis were studied. These functions were found to be normal when leukocytes from the patients were incubated in media containing normal human serum. Phagocytosis of Staphylococcus albus and polystyrene balls by both patient and normal leukocytes was diminished when the cells were incubated in hypogammaglobulinemic plasma. A similar defect in opsonization by patient plasma was also noted for pneumococci, Escherichia coli and variably with Staphylococcus aureus. Both patient and normal sera had equivalent levels of heat-labile S. albus opsonins; normal serum, however, contained heat-stable S. albus-specific absorbable opsonins in significantly greater quantities to account for its superior opsonic capacity. The addition of commercial gamma globulin or purified IgG to hypogammaglobulinemic sera restored full S. albus opsonic activity. The relevancy of these observations to the impaired host defenses in these patients will be discussed.
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PMID:Leukocytic function in hypogammaglobulinemia. 419 88


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