Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019209 (hepatomegaly)
 5,798 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent surveys in Ngamiland, Botswana, indicate increasing prevalence of Schistosoma mansoni infections. With the introduction of a schistosomiasis control programme, 354 of 373 schoolchildren were examined quantitatively for eggs of S. mansoni, and 317 were examined clinically for hepato- and splenomegaly. 80.5% of the children examined parasitologically were found infected. Among these the arithmetric mean egg output was 744.7 and the geometric mean 307.3 eggs per gram of faeces (epg), 46.0% were excreting more than 400 epg. 23 children were found to have an enlarged liver, whereas none was found with enlarged spleen. 21 of these had schistosomiasis. The prevalence of hepatomegaly was highest among those excreting above 1600 epg. Also the mean size of the enlarged livers increased with intensity of infection.
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PMID:Schistosoma mansoni: intensity of infection and morbidity among schoolchildren in Matlapaneng, Ngamiland, Botswana. 312 13

Circulating immune complexes (CIC), adult schistosome antibody, and total immunoglobulin concentrations were estimated in sera from 35 chronic Schistosoma mansoni patients with different infection intensities and different pathological complications. High CIC levels were present in about one-third (10/35) of the sera. Most of the patients (9/10) with elevated CIC levels also had hepatomegaly or hepatosplenomegaly. This finding is significant in the pathogenesis of schistosomal liver fibrosis and may also apply to other liver diseases, especially cirrhosis. No correlation was found between infection intensity as judged by stool egg counts and CIC levels. A reverse relationship was observed between the level of anti-adult worm IgG and CIC levels. CIC levels were elevated within 7 and 28 days after treatment in most patients. Hypergammaglobulinaemia was detected in most sera.
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PMID:Circulating immune complex levels in patients with schistosomiasis and complications. 313 Jun 85

In 1985 and 1986, an epidemiological survey was carried out in a focus of Schistosoma mansoni located in Kara (Togo). 412 children, 6 months to 15 years old, were examined. The prevalence of schistosomiasis mansoni, evaluated on parasitological and serological data, was of 51.5%. No parasites were found in children before the age of 4. Beyond, the prevalence increase with age; being more important in girls before 10 years and equivalent for both sexes afterwards. Moreover the number of children with hepatomegaly, was significantly higher (p less than 0.001) in patients with schistosomiasis (9.6%), confirming previous results of 1981. Since this date, the prevalence has decreased from 79.6 to 51.5% just as eggs burden in the stools and mean antibodies titers. The explanation of this phenomenon remains unknown.
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PMID:[An epidemiologic study of a focus of Schistosoma mansoni bilharziasis in Kara (North Togo)]. 314 19

Investigations of schistosomiasis mansoni in 218 Yemeni agricultural workers in the San Joaquin Valley of California revealed a prevalence of 56%. In those infected, quantitative egg counts performed by the Kato thick smear method revealed that 57% had light infections (1-100 eggs/g), 27% moderate infections (101-400 eggs/g), and 16% heavy infections (greater than 400 eggs/g; mean--918 eggs/g). The Yemeni had been migrating to the USA for the past 20 years, a period in which the prevalence of schistosomiasis had remained constant in the Yemen. The prevalence of schistosomiasis in those who had been away from Yemen for less than 5 years was 59% with a mean egg output of 236 eggs/g, but in those away for more than 5 years (up to 20 years) it was 32% with a mean egg output of 75% eggs/g. This is in spite of the fact that 75% of the latter had returned to Yemen for short visits. Statistical analysis by the Fisher's exact probability test revealed a significantly lower egg output in those away from Yemen more than 5 years. On the basis of these findings the mean life span of the Yemen strain of Schistosoma mansoni in man was estimated to be between 5 and 10 years. The presence of disease was assessed in this population by traditional medical means without prior knowledge of the status of the infection in the individuals examined. Under these circumstances, there were no differences in symptoms such as weakness, diarrhea and abdominal pain among the uninfected proportion of the population, total infected group and a small subgroup of those most heavily infected. None of the patients had hepatomegaly and only two had splenomegaly--one lightly and the other heavily infected. Because of the toxicity of antischistosomal drugs and the lack of treatment facilities only the 22 most heavily infected (greater than 200 eggs/g) of the 122 individuals with schistosomiasis mansoni were treated with niridazole. In addition the two individuals with splenomegaly were treated with antimony dimercaptosuccinate. Side effects, though common, were not severe. Although follow-up in this migrant population was poor the nine patients examined 3 to 7 months after treatment showed a mean decrease in egg output of 97%.
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PMID:Schistosomiasis mansoni in Yemeni in California: duration of infection, presence of disease, therapeutic management. 445 Dec 30

Golden hamsters were used to determine whether intraperitoneal Zn supplementation can improve the outcome of infection with Schistosoma mansoni. The animals were divided into two groups; one received an initial intraperitoneal dose of Zn chloride (0.75 mg 100 g body wt.-1) followed by booster doses (0.25 mg 100 g body wt.-1) twice weekly for four weeks, the other group received no Zn supplement. After one week, when the initial and one booster doses were given, half of the animals in each group were exposed to S. mansoni cercariae for two hours using body immersion technique. After five weeks (one week after the final Zn supplement) the animals were killed, their worm burdens determined and their livers, kidneys, spleens, hearts and sera examined. There was a significant reduction in total worm counts in the Zn supplemented group (P less than 0.05). Also, Zn supplementation of infected animals protected them against the hepatomegaly which is very often associated with schistosomiasis. Spleen weight and Zn uptake were highest in the infected Zn supplemented group, indicating that this organ requires larger amounts of Zn to perform its various Zn-dependent immunological functions. The data suggest that Zn may enhance the ability of the body organs to resist some of the harmful effects of schistosomal infection.
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PMID:Effect of zinc supplementation on S. mansoni-infected hamsters. 666 Sep 57

From this comparison of 37 black children with hepatic schistosomiasis (HS) and 53 with intestinal Schistosoma mansoni (IS) living in an endemic area, we propose easily identifiable clinical features of mild HS. These patients were generally well nourished school-age children who seldom complained of dysentery but who had a firm hepatomegaly with predominant enlargement of the left lobe and a firm splenomegaly. They were also mildly anaemic (9.4 +/- 2.2 g/dl) and had low serum albumin (30 +/- 7 g/l), raised aspartate transaminase (36 +/- 31 u/l) and high globulins (53 +/- 15 g/l). The implications of the absence of severe hepatosplenic schistosomiasis in many of these children are discussed.
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PMID:Clinical recognition of mild hepatic schistosomiasis in an endemic area. 671 May 66

Forty-one Egyptian schoolchildren (36 boys and five girls; age, 12-16 years) who were heavily infected with Schistosoma mansoni were studied. Symptomatic subjects had swimmer's itch and hematochezia. Hepatomegaly was found in 39 and splenomegaly in 31 children. All subjects had eosinophilia, 13 had anemia, 31 had elevated levels of serum globulins, and nine had elevated levels of alkaline phosphatase. All but one subject had antibody to hepatitis A virus, and 26 had antibody to hepatitis B core antigen, antibody to hepatitis B surface antigen, or both. Oxamniquine was given in single daily doses of 20 mg/kg of body weight for either two or three days and cured 50% and 85%, respectively, of subjects treated; ova excretion was reduced by 86%-93% for up to 12 months. Morbidity was associated with heavy S. mansoni infection. Therapy with oxamniquine was safe and efficacious.
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PMID:Clinical characteristics and response to therapy in Egyptian children heavily infected with Schistosoma mansoni. 708 3

Pronounced differences in resistance to reinfection and pathology were observed among various strains of mice infected with Schistosoma mansoni. When comparing strains, the level of resistance induced by a 12-week infection correlated closely with the degree of portal blood pressure elevation and number of lung egg granulomas, but did not correlate with other pathological parameters or with the number of worms or tissue eggs. Among individual mice of the same strain, however, resistance was proportional to the number of worms and tissue eggs. Nmri strain mice infected for more than a year remained highly resistant to reinfection and continued to shunt eggs into the lungs, but showed considerable resolution of portal hypertension, hepatomegaly and splenomegaly. No association was observed among mouse strains between the mortality resulting from a primary infection and the severity of any of the pathological parameters which were measured.
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PMID:Relationship between acquired resistance, portal hypertension, and lung granulomas in ten strains of mice infected with Schistosoma mansoni. 725 92

Clinical gastro-intestinal manifestations were studied in 34 patients in the initial phase of schistosomiasis mansoni. The patients, all men, were of similar age and in similar nutritional condition and had been infected simultaneously at the same transmission site. Most (85%) showed some gastro-intestinal sign or symptom, generally of light or moderate intensity; 56% had liquid or pasty diarrhoea, 41% abdominal pain, 29% hepatomegaly, 21% dysentery, 15% anorexia, 12% pain on colon palpation and 9% nausea and/or vomiting. High worm burden was associated with blood in faeces but apparently not with any other clinical manifestation. There was no apparent association between any clinical manifestation and peripheral-blood eosinophil counts or titres of IgE specific for Schistosoma mansoni (evaluated by the area of immediate intradermal reaction to injected adult worm antigen). The absence of association between worm burden and nearly all the clinical gastro-intestinal manifestations strengthens the concept that factors other than worm burden, such as host reactivity, constitute important pathogenetic elements in the initial phase of schistosomiasis mansoni.
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PMID:Gastro-intestinal manifestations of the initial phase of schistosomiasis mansoni. 766 18

Schistosoma mansoni was introduced in the Richard Toll area (Senegal) around 1988, probably due to man-made ecological changes in the Senegal river basin. Since 1991, we investigate the community of Ndombo, close to Richard Toll. Four random population samples of approximately 400 subjects are surveyed, starting at 8 months intervals. Each cohort is examined parasitologically (Kato-Katz), clinically, serologically (circulating antigen and antibody profiles); treated with praziquantel 40 mg/kg; and followed up 6-12 weeks, 1 and 2 years after treatment. Water contact patterns and snail densities are longitudinally surveyed. In the first cohort, prevalence of infection was 91%, with 41% excreting over 1000 eggs per gram (epg); the mean egg count was 646 epg, individual counts up to 24,000 epg. Prevalences remained almost 100%, but egg counts declined strongly in adults, in spite of continued exposure and the supposed lack of acquired immunity. Antigen detection in serum and urine confirmed that the egg counts genuinely reflect variations of worm burdens. Serum circulating anodic antigen (CAA) provided intriguing epidemiological information on worm burdens, while circulating cathodic antigen (CCA) showed promise for non-invasive diagnosis and screening. So far, similar epidemiological results were found in subsequent cohorts, although some variations were observed, possibly due to seasonal transmission fluctuations. IgE levels increased with age, while IgG4 peaked in the age-group 10-19 years. IgE and IgG4-levels against adult worm antigen (AWA) and soluble egg antigen (SEA) increased between cohort 1 and cohort 3 in almost all age-groups. In all 3 cohorts examined so far a strong correlation between IgG4 and pre-treatment egg-load was observed. Further follow-up and analysis, and comparison with chronically infected populations will provide insight in the development of acquired immunity. Abdominal discomfort was reported by 61% and diarrhoea by 33% of the subjects in the first cohort; mild hepatomegaly was found in 16%, splenomegaly in 0.5%. There was no correlation between frequency of symptoms and egg counts. This low morbidity, in spite of intense infections, was confirmed by ultrasound, and may be due to the recent nature of the focus. In the first cohort, 82% of treated subjects still excreted eggs 12 weeks after treatment, though egg counts declined strongly. Antigen detection confirmed these results. Parasitological negativation rates in subsequent cohorts, followed up sooner after treatment, improved but remained remarkably low. The low drug efficacy may be due to very rapid reinfection (though further reinfection after one year was limited), and/or to the lack of immunity in the population. Reduced susceptibility of the local schistosome strain can not be excluded, however. Praziquantel treatment provoked impressive but transient side effects (colics, vomiting, urticaria, oedema), the frequency of which correlated with intensity of infection.
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PMID:Epidemiology, immunology and chemotherapy of Schistosoma mansoni infections in a recently exposed community in Senegal. 782 23


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