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Query: UMLS:C0019209 (hepatomegaly)
 5,798 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This article attempts to evaluate the criteria used in the diagnosis of schistosomiasis in an endemic bilharzial area. The discussion deals with the possible value of criteria such as egg recovery, rectal biopsy specimens, eosinophilia, hepatomegaly, and serological and skin tests. A rational approach to the treatment of patients with schistosomiasis is proposed and features such as probability of re-infection are taken into account.
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PMID:Observations on the diagnosis and treatment of schistosomiasis in an endemic area. 31 38

Specific IgM and IgG antibody to a polysaccharide present in the epithelial cells of the gut of adult schistosomes was measured in four groups of infected patients: I) patients with documented acute schistosomiasis; II) Americans exposed to schistosomiasis within the preceding 0--4 years; III) chronically and heavily infected patients, mostly from Puerto Rico, without hepatomegaly or hepatosplenomegaly; and IV) heavily infected Brazilian children with hepatic or hepatosplenic schistosomiasis. Specific IgM and IgG titers were both highest in the acute Group I patients and lowest in the chronically infected Groups III and IV. Total IgG and IgM levels were compared to specific antibody titers. Immunoglobulin levels tended to follow specific antibody titers except in the chronically infected Groups III and IV in which total IgG rose to high levels. The decrease in specific antigen titers over the course of time occurred despite continued antigenic stimulation and suggests a modulation of the humoral response. The mechanism remains obscure.
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PMID:Antibody response to a polysaccharide antigen present in the schistosome gut. II. Modulation of antibody response. 36 58

In schistosomiasis mansoni, the pathogenesis of hepatosplenic disease has been shown to be due primarily to immune mechanisms. The present study was designed to examine the relationship between the development of schistosomal hepatosplenomegaly in Egyptian school children and the HLA antigens. Two groups of schistosome-infected children with similar fecal egg counts were examined: one group (23 children) had no clinically demonstrable hepatosplenomegaly whereas all the children (28) in the second group suffered from liver enlargement. Furthermore, 13 of the 28 individuals in the latter group had splenomegaly as well. Our results show that hepatosplenomegaly was related to the presence of two HLA antigens: HLA AI and B5. The average relative risk of developing hepatomegaly is 29 for HLA AI and 18.9 for 55.6. Furthermore, the severity of hepatomegaly was correlated with the presence of these two HLA antigens. These findings represent a step toward elucidating the factors controlling the pathogenic mechanisms in human schistosomiasis mansoni.
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PMID:Histocompatibilty-linked susceptibility for hepatospleenomegaly in human schistosomiasis mansoni. 47 1

Serum laminin level was measured in chronic hepatic schistosomiasis. A significant increase in the mean serum laminin levels was observed in patients with hepatosplenic (HS) schistosomiasis (2.57 +/- 0.83 U/ml), as compared to those in patients with the hepatointestinal (HI) form of the disease (1.38 +/- 0.45-U/ml) and in the control group (1.15 +/- 0.31 U/ml). In the HS patients there was a significant direct relation between serum laminin and percutaneous splenic pulp pressure (r = 0.68). These findings are compatible with an increased production of laminin in hepatosplenic schistosomiasis with may be related to the observed enlarged liver and spleen basement membranes in such disease.
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PMID:Serum laminin in hepatosplenic human schistosomiasis. 134 82

To determine whether chronic Schistosoma mansoni infection interferes with hepatitis B virus (HBV) immunization, 308 schoolchildren aged 6-12 years with no evidence of prior HBV infection (156 with active schistosomiasis) were vaccinated with three 5-micrograms injections of recombinant DNA-derived HBV vaccine. The vaccine was given in the deltoid muscle at time 0 and 1 and 7 months later. All vaccinees were examined 1 and 3 years after vaccination for quantitative antibody to hepatitis B surface antigen (anti-HBs). Seroconversion was detected in 284 vaccinated children (92%), of whom 271 had a good (51-300 mIU/mL) or excellent (greater than 300 mIU/mL) anti-HBs response. Sixteen other children (5%) had evidence of natural HBV infection (antibody to hepatitis B core antigen). Of those with good or excellent response, 99% retained high antibody titers for 3 years. Response was not influenced by S. mansoni infection. Hepatomegaly and splenomegaly were associated with reduced vaccine response.
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PMID:Efficacy of hepatitis B vaccination in primary school children from a village endemic for Schistosoma mansoni. 138 97

Serum laminin levels were measured in patients with chronic hepatic schistosomiasis. A significant increase in the mean serum laminin level was observed in 14 patients with hepatosplenic schistosomiasis (2.57 +/- 0.83 units/ml [standard deviation]) compared to the level in 10 patients with the hepatointestinal form of the disease (1.38 +/- 0.45 units/ml) and in the control group of 10 (1.15 +/- 0.31 units/ml). In the hepatosplenic patients there was a significant direct relation between serum laminin and percutaneous splenic pulp pressure (r = 0.68). However, this relation was not observed with either liver function tests or levels of N-terminal propeptides of type III procollagen. These findings are compatible with an increased production of laminin in hepatosplenic schistosomiasis, which may be related to the observed enlarged liver and spleen basement membranes in such disease.
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PMID:Serum laminin in hepatic schistosomiasis. 144 Jul 82

The relationship between intensity of Schistosoma mansoni infection and the degree of related morbidity was suspected to differ locally within the Machakos district of Kenya. To test this possibility, prevalences of hepatomegaly and splenomegaly among 1483 school children were compared between 2 areas, Kangundo and Kambu, within this district. These areas, which were similar in many geographical and economic respects and populated by the same tribe (Akamba), had comparable levels of S. mansoni infection and no S. haematobium infection. A relationship was observed between the prevalence of hepatomegaly and intensity of S. mansoni infection, which showed no consistent difference between the 2 areas. In contrast, a relationship between the prevalence of splenomegaly and intensity of S. mansoni infection was observed only in the Kambu schools, and not in the Kangundo schools where the overall prevalence of splenomegaly was much lower. It was possible that part of the splenomegaly observed in Kambu was due to malaria. However, the observation that malaria and schistosomiasis in 2 Kambu schools were not positively correlated allowed approximations to be made of the relative contributions of each to the prevalence of splenomegaly. It was concluded that, in a school close to the river that formed the main transmission site of S. mansoni, schistosomiasis-related hepatosplenomegaly was present in at least 17% of children. The reason for the high prevalence in Kambu of hepatosplenic schistosomiasis remains uncertain, but it could include a synergistic interaction of schistosome infection with malaria.
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PMID:Differences in the rate of hepatosplenomegaly due to Schistosoma mansoni infection between two areas in Machakos District, Kenya. 175 56

A comparison was made of the long-term impact of different methods of administration of chemotherapy (oxamniquine, 30 mg/kg in divided doses; or praziquantel, 40 mg/kg) on prevalence and intensity of Schistosoma mansoni infection in four areas in Kangundo Location, Machakos District, Kenya. In Area A, treatment was offered in October 1983 and again in April 1985 to all infected individuals. In Area H, treatment was offered in April 1985 to individuals excreting greater than or equal to 100 eggs per gram (epg) of faeces. In Area S, treatment was offered in April 1985 to all infected school children, within the framework of the primary schools. In the witness area, Area W, treatment was given in April 1985, for ethical reasons, to a small number of individuals excreting greater than or equal to 800 epg. Prevalence and intensities of infection were subsequently monitored at yearly intervals for three complete post-treatment years. In the Area S schools, clinical examination was also carried out at yearly intervals. Treatment of all infected individuals on two occasions (Area A) was the most effective and long-lasting way of reducing prevalence and intensity of infection. In this area, however, some earlier interventions had been carried out and pre-treatment intensities were lower than in the other areas. Treatment only of infected schoolchildren (Area S) also had a marked and prolonged effect, comparable to or better than treatment of individuals with heavy infections (Area H). Treatment of infected schoolchildren also caused a persistent reduction in the prevalence of hepatomegaly, and there was suggestive evidence from intensities of infection in community stool surveys (but not from incidence rates) of an effect on transmission. In all study areas, reinfection was most rapid and most intense among children. These findings are discussed in the light of theoretical considerations and of results from other studies, both on schistosomiasis and on intestinal helminths. We conclude that, in areas of low morbidity such as Kangundo, chemotherapy of schoolchildren only, at intervals of up to 3 years, is a satisfactory way of producing a long-term reduction in both intensity of infection and morbidity.
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PMID:Comparison of different chemotherapy strategies against Schistosoma mansoni in Machakos District, Kenya: effects on human infection and morbidity. 178 Jan 71

The efficacy of the highly selective antischistosomal combination chemotherapy with tubercidin (7-deazaadenosine) plus nitrobenzylthioinosine 5'-monophosphate (NBMPR-P), [el Kouni et al., Proc Natl Acad Sci USA 80: 6667-6670, 1983; el Kouni et al., Biochem Pharmacol 36: 3815-3821, 1987] was examined against chronic and advanced stages of schistosomiasis in mice. Administration of four successive daily doses of tubercidin (5 mg/kg/day) plus NBMPR-P (25 mg/kg/day) to Schistosoma mansoni-infected mice beginning 5, 6, 7 and 8 weeks post-infection and monitored for 22 weeks was very effective against the parasite. It resulted in a marked increase in survivorship of treated mice. Repetition of the dose-regimen after a 10-day rest period was even more effective. However, survivorship of infected animals decreased with the delay of therapy. Early treatment (5 weeks post-infection) resulted in 100% survival compared to 13% only for untreated animals. If therapy was instituted at 8 weeks post-infection, only 70% of the treated mice survived. Treated animals appeared healthy and were found to have less splenomegaly and hepatomegaly. Combination therapy also caused a significant reduction in the number of worms as well as the number of eggs in the liver and small intestine. However, these differences diminished as the treatment was delayed. The number of eggs in the liver was reduced from an average of 120,000 eggs per liver in untreated animals to approximately 16,000 eggs per liver when treated at 5 weeks post-infection. When treatment was delayed to 8 weeks post-infection, the reduction in liver egg count was not as dramatic (88,000 eggs per liver). Similarly, the number of eggs was reduced in the intestine from 1,759 to an average of 58 and 860 eggs per cm2 of the intestine when the mice were treated at 5 and 8 weeks post-infection respectively. However, some worms survived and resumed egg production after an extended period of recuperation. Histological examination indicated that combination therapy was effective in preventing the formation of new egg granulomas but not on pre-existing granulomas.
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PMID:Efficacy of combination therapy with tubercidin and nitrobenzylthioinosine 5'-monophosphate against chronic and advanced stages of schistosomiasis. 190 Jan 58

Parasitological, clinical, and sonographic examinations were performed on 309 school children in a village endemic for schistosomiasis mansoni. Data from the 255 denying treatment within the previous 2 years were analysed separately. On a single Kato examination 42% were uninfected; the remainder had light (26%), moderate (21%), or heavy (11%) infections with Schistosoma mansoni. Hepatomegaly (53%) and palpable spleens (35%) were common but clinical and parasitological findings often were unrelated. Abdominal sonography also demonstrated a high frequency of hepatomegaly (82%) and splenomegaly (49%). Sonographically determined liver span and spleen size correlated with the egg count. Sonographic lesions of periportal fibrosis of schistosomiasis mansoni with thickening of portal tracts and portal vein walls were frequently present and more common in infected than in uninfected children, and were correlated with the number of S. mansoni ova in the stool. Ultrasonographically detected periportal fibrosis was a reliable measurement of the prevalence and morbidity of schistosomiasis mansoni in this population, and provided very useful information, even when the parasitological and clinical findings were equivocal.
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PMID:Sonographic studies of schoolchildren in a village endemic for Schistosoma mansoni. 211 46


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