Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017536 (giardiasis)
 1,714 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There is controversy both in regard to the severity of small bowel mucosal damage attributable to giardiasis and to the causal relationship of these changes to the associated diarrhoea. In this series of 17 consecutive patients with giardiasis, small bowel histology and diarrhoea were independently assessed and compared. Disaccharidase assays were performed in 16 of these patients and a repeat biopsy obtained in seven cases. On histological examination the villous architecture varied from normal to sub-total villous atrophy. When these changes were compared with the severity of diarrhoea, a direct correlation was obtained, the more severe symptoms being associated with the more severe villous changes. Repeat biopsy after treatment demonstrated improvement in the histology which correlated with improvement in diarrhoea. Lactase activity was low in all patients with moderate or severe diarrhoea as well as in some patients with mild diarrhoea, two of whom had normal histology. This series demonstrates the occurrence of a spectrum of mucosal changes in giardiasis and supports the concept that these changes mediate the diarrhoea associated with this gut parasite.
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PMID:Histopathology in giardiasis: a correlation with diarrhoea. 10 99

Sixteen children with refractory diarrhea and three malnourished children who had frequent episodes of acute gastroenteritis but little diarrhea at the time of hospital admission, were studied by peroral upper small intestinal biopsy. Six children were adequately nourished; five children weighed 62 to 79% of expected weight and eight weighed less than 60% of expected weight. Two of the malnourished children had giardiasis. Pathogenic bacteria were found in only one case. Varying degrees of mucosal atrophy with reduction of mean villous height were seen in 18 cases. The concentration of mononuclear inflammatory cells and plasma cells was about half that seen in well-nourished children with severe nongastrointestinal infections. The concentration of mononuclear cells in the lamina propria was about twice that seen in normal adults. The proportions of IgA-producing cells and cells that stained for secretory component were significantly reduced, as compared with normal adult control values. This reduction was most striking in children with malnutrition complicated by giardiasis. Enzyme histochemical studies were performed for leucine aminopeptidase, alkaline phosphatase and acid phosphatase. There was a tendency for considerably reduced acid phosphatase activity in all clinical groups (kwashiorkor, marasmic kwashiorkor and marasmus) of growth-retarded infants.
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PMID:Infantile jejunal mucosa in infection and malnutrition. 10 19

The practical approach to the investigation of diarrhea must be logical and based on anatomic considerations. The site of the underlying disorder may be determined by the clinical picture, and the logic of investigation will be influenced by the history. Important specific investigation in a case of colonic diarrhea include a careful rectal examination, stool inspection, sigmoidoscopy, rectal biopsy and barium enema study. Colonoscopy has been used, but its role has yet to be defined. In a case of small-bowel steatorrhea or diarrhea quantitative chemical estimation of the daily output of stool fat is useful, and to this investigation is added a small-bowel radiograph series and, if the radiographic findings are abnormal, small-bowel biopsy. Other investigations for small-bowel disease may include the breath test with carbon-14-labelled glycocholic acid, the lactose tolerance test, duodenal aspiration for giardiasis, analysis of serum immunoglobulins and, on occasion, isolation of vasoactive intestinal polypeptide hormone (which may aid the diagnosis of functioning tumours of the pancreas or small bowel). Investigations for pancreatic steatorrhea include abdominal radiography, performance of the secretin test and testing of the response to pancreatic replacement therapy. In some patients it may be useful to use endoscopic retrograde cholangiopancreatography to differentiate pancreatic carcinoma and chronic pancreatitis.
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PMID:Symposium on diarrhea. 3. Investigation of chronic diarrhea. 19 Nov 73

An adult with the late onset immunodeficiency syndrome developed intractable diarrhea. Widespread cytomegalovirus (CMV) infection of the gastrointestinal tract was detected antemortem with detailed morphological studies and viral culture. The CMV-type cells were especially numerous in his severely ulcerated colon. Electron microscopy of infected cells in rectal biopsy material revealed the characteristic features of CMV infection. It is likely that the CMV infection contributed to the symptom complex and the mucosal injury. Unusual opportunistic infections as a cause of diarrhea should be considered in patients with late onset immunodefociency, especially if Giardiasis is ruled out.
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PMID:Cytomegalovirus infection of the gastrointestinal tract in a patient with late onset immunodeficiency syndrome. 19 23

Two patients presented with similar peripheral neuropathic symptoms. Muscle denervation was shown by electromyography and muscle biopsy. Motor and sensory nerve conduction studies were normal. Both patients had intestinal giardiasis: 1 had asymptomatic steatorrhoea, and the other had diarrhoea and abdominal pain. Treatment with metronidazole abolished the gastrointestinal symptoms. After a delay of several months the neurological symptoms also gradually improved. No other cause of peripheral neuropathy was apparent on investigation, and the relationship between the intestinal giardiasis and the peripheral neuropathy is discussed.
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PMID:Intestinal giardiasis, steatorrhoea and peripheral nerve dysfunction. 21 1

Among 10,418 patients of a Prague hospital, a plain infection with intestinal parasitic protozoans was identified in 1,319 persons (12.7%). Of these, 3.5% were infested with Giardia intestinalis, 0.3% with Entamoeba histolytica forma minuta, 5.7% with Endolimax nana. We evaluated the frequency of findings of protozoans in various clinical diagnoses. A statistically significant increase in frequency was recorded for E. nana in diagnoses of eosinophilia, giardiasis, amoebiasis and helminthiasis. A slight increase above the average was found for Entamoeba coli in diagnoses of giardiasis and helminthiasis. Most cases of infection with Entamoeba histolytica were associated with a stay abroad. No increase in the frequency of these protozoans was recorded for patients with diarrhea. An analysis of the results indicated that a nonpathogenic amoeba might participate in the origin of intestinal disorders in man.
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PMID:Contribution to the problem of the so-called nonpathogenic amoebae in the intestine of man. 21 7

An 8-year-old boy presented with idiopathic late-onset immunoglobulin deficiency manifested principally by recurrent suppurative chest infections and chronic diarrhoea with malabsorption. Nodular lymphoid hyperplasia and giardiasis were shown on small bowel biopsy. Investigation of the immune system showed low serum levels of IgG, IgM, and IgA, negative skin tests to four recall antigens, absent mixed lymphocyte reactivity, and impared lymphocyte responses to mitogens in vitro. Serum complement and granulocyte function studies were normal. Maintenance therapy with gammaglobulin and antibiotics gave a good response.
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PMID:Idiopathic late-onset immunoglobulin deficiency with associated defect in cell-mediated immunity. 30 36

One hundred children suffering from symptomatic giardiasis were treated with either tinidazole or metronidazole in random order. Both the drugs were given as a single oral dose calculated on the basis of 50 mg/kg body weight. Parasitological and clinical cure was obtained in 40 (80%) of 50 patients given tinidazole and in 18(36%) of 50 patients given metronidazole. This difference in cure rates was significant (p less than 0.01). Furthermore, control of diarrhoea and negative stool conversion for G. lamblia were achieved earlier with tinidazole than with metronidazole, the differences being significant (p less than 0.01) from the 8th post-treatment day. Gastro-intestinal side-effects of mild degree occurred in 6 patients on tinidazole and in 2 patients on metronidazole; they comprised nausea, vomiting, and bitter taste. Neither drug caused any abnormal deviation in blood counts or in biochemical tests of liver and kidney function.
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PMID:Single-dose treatment of giardiasis in children: a comparison of tinidazole and metronidazole. 34 Jan 34

Patients with B cell deficiency have a high incidence of prolonged Giardia lamblia infection of the gastrointestinal tract that causes symptoms of malabsorption with villus flattening. The changes are reversible with therapy directed against Giardia. There is a high incidence of pernicious anaemia in patients with agammaglobulinaemia. Those with abnormal B lymphocytes tend to develop lymphoid nodular hyperplasia. Gastrointestinal disease is rare in boys with X-linked agammaglobulinaemia when compared with adults with the 'acquired' or common variable form of the disease. T cell deficiency results in intractable diarrhoea and monilial infection of the gastrointestinal tract.
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PMID:Gastrointestinal complications of immunodeficiency syndromes. 34 24

To prevent diarrhea, efforts must be directed toward decreasing environmental contamination of enteropathogens, altering exposure of persons to naturally occurring agents, or to increasing host tolerance to prevalent enteropathogens. A vaccine is feasible in the control of certain enteric infections among high risk groups: typhoid fever and cholera, in areas of hyperendemicity or during an epidemic, shigellosis in institutionalized populations that are at risk to develop illness due to known prevalent serotypes, enterotoxigenic Escherichia coli for US travelers to Latin America, and perhaps rotavirus for all children under 3 years of age. In diarrhea, the most useful form of treatment is an oral glucose/electrolyte solution, which in most cases will prevent dehydration. Lactose containing foods should be removed from the diet early in the course of diarrhea. Antimicrobial agents are necessary in the treatment of typhoid fever, are useful in the treatment of shigellosis, giardiasis, and amebiasis, and are contraindicated in intestinal salmonellosis.
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PMID:Interventions in diarrheas of infants and young children. 35 24


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