Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019214 (hepatosplenomegaly)
 4,408 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The assessment of morbidity caused by chronic parasitic infections in the populations of endemic areas has remained difficult and controversial. Contributing to this predicament is the frequent occurrence of multiple infections with agents that can cause a wide range of clinical manifestations, from the frequent symptomless carrier state to overt disease with more or less specific clinical manifestations. In the interpretation of the complex morbidity patterns found in rural populations of tropical countries, it is often difficult to make a clear determination of cause and effect. The situations is further complicated by the low degree of pathognomicity of the clinical manifestations of even the advanced stages of certain parasitic diseases. The paper gives examples that illustrate the interaction between endemic malaria and schistosomiasis as important causes of hepatosplenomegaly. Also shown in the paper are the inter-relationships between the nutritional status and the number of multiple infections with parasites found in African villages as well as the association between habitual coca leaf chewing, malnutrition and hookworm disease in a Peruvian community of mixed ethnic origin. The paper describes micro-epidemiological features of poly-parasitism by comparing the prevalence and intensity of infection with Onchocerca volvulus, Schistosoma mansoni and S; haematobium between sub-groups in the village population who have different sources of domestic water supply. In two African villages with endemic schistosomiasis where mass treatment will be administered, only 25% of the residents with parasitologically confirmed S. haematobium infection and 12% of those with S. mansoni had single infection; the remaining majority had at least one additional patent parasitic infection of public health importance.
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PMID:Epidemiology of poly-parasitism. IV. Combined effects on the state of health. 72 41

Twenty male patients (mean age 23 years) with Schistosoma mansoni infections (mean egg count 429 +/- 311/g feces) were each treated with oxamniquine orally in a single daily dose of 20 mg/kg for 3 consecutive days. Seventeen patients had hepatosplenomegaly, two of these had ascites. Three patients had diffuse colonic polyposis, one of these had ascites. Except for one who developed mild hematemesis 3 days after treatment, all patients tolerated the drug very well. However, 11 patients developed a fever 24 to 48 hours after completing treatment, which lasted for 2-3 days and coincided with increased excretion of schistosomal antigens in urine. Three months after completing therapy, all except one young patient ceased to have live egge in the stools or rectal tissue. Six months after treatment, three patients with colonic polyposis showed marked clinical improvement and sigmoidoscopic and barium enema examination demonstrated almost complete disappearance of all polyps.
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PMID:Treatment of complicated schistosomiasis mansoni with oxamniquine. 72 34

The effect of cyclosporin A (CsA) on schistosomal nephropathy in infected mice with Schistosoma mansoni (S. Mansoni) has been investigated. Infected mice were orally treated with 50 mg/kg body weight of CsA for 5 consecutive days at the 8th, 12th, 16th week postinfection (p.i.). Four weeks after drug therapy, CsA aborted and retarded the progression of glomerular injury in all stages of the disease; particularly with early drug therapy. This was evidenced by the reduction in electron dense deposits and weak positivity by fluorescent microscope. This response was accompanied by amelioration of hepatosplenomegaly. The effects of CsA could be related to its known immunosuppressive effect on T-helper (Th) cells. Moreover, CsA had a profound anti-schistosomal activity as demonstrated by the significant decrease in worm burden specially female worms, and the increase in the percentage of mature and dead eggs in intestinal mucosa in this study. So, CsA would ameliorate the glomerular lesion in early stages of schistosomal nephropathy, mainly by its immunosuppressive effect, but in later stages, the direct anti-schistosomicidal effect would take the upper hand.
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PMID:Schistosomal nephropathy: effect of ciclosporin A (CsA) in murine schistosomiasis mansoni. 157 69

Serum levels of 2 schistosome circulating antigens, the circulating anodic antigen (CAA) and the circulating cathodic antigen (CAA), were determined in persons infected with Schistosoma mansoni in Brazil. Sensitive monoclonal antibody-based enzyme-linked immunosorbent assays were used to measure levels of the 2 antigens. The study group consisted of 38 individuals with intestinal schistosomiasis, and 20 persons with the hepatosplenic form of the disease. Age and intensity of infection were comparable for the 2 groups. CAA was detected in 65.5% of all patients' sera and CCA was found in the serum of 82.8% of all patients. CAA levels correlated well with the egg output, as determined by duplicate Kato-Katz smears; CCA was significantly positively correlated with egg output in patients with intestinal schistosomiasis only. Whereas no significant difference was found between CAA titre in patients with intestinal schistosomiasis and those with the hepatosplenic form, a significantly higher CCA titre was found in patients with hepatosplenomegaly compared to patients with intestinal schistosomiasis.
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PMID:Levels of the schistosome circulating anodic and cathodic antigens in serum of schistosomiasis patients from Brazil. 180 47

Because dual infection with Schistosoma mansoni and hepatitis B may lead to severe liver disease, populations living in schistosomiasis-endemic areas might benefit if effectively immunized against hepatitis B. To determine whether a plasma-derived hepatitis B vaccine is immunogenic in patients with schistosomiasis, 32 individuals infected with S. mansoni were given three 20-micrograms doses of Heptavax-B vaccine and treated with praziquantel. Antibody to hepatitis B surface antigen developed in 90.6% of the study subjects after three doses of vaccine. Five patients (15.6%) had a weak response to the vaccine, and three patients (9.4%) failed to develop antibody. A weak or failed response to the vaccine was significantly associated with the presence of hepatosplenomegaly. A plasma-derived vaccine is immunogenic for persons infected with S. mansoni; however, vaccine response is diminished in hepatosplenic schistosomiasis.
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PMID:Immunogenicity of hepatitis B vaccine in patients infected with Schistosoma mansoni. 295 63

The basis for development of hepatosplenic disease and attendant morbidity in Schistosoma mansoni-infected individuals is uncertain but may relate to defective modulation of immunopathology. Individuals 14 to 30 years of age from a village in the Nile Delta in Egypt were selected for study: 32 were infected with S. mansoni but lacked hepatosplenomegaly (mean fecal egg excretion +/- standard error of the mean, 1,142 +/- 79 eggs per g), 9 had S. mansoni infection and hepatosplenomegaly (1,267 +/- 197 eggs per g), and 12 were uninfected. The ratio of OKT4 helper/OKT8 suppressor cells in peripheral blood mononuclear cells was reduced in infected subjects without hepatosplenomegaly to 1.4 +/- 0.1 compared with a ratio of 1.7 +/- 0.1 (P less than 0.05) in uninfected subjects. In contrast, this ratio was increased in the group with hepatosplenomegaly to 2.7 +/- 0.3 (P less than 0.01). Schistosome antigen-induced [3H]thymidine incorporation in peripheral blood mononuclear cells was comparable in infected subjects without (5,837 +/- 1,009 cpm) and with (3,329 +/- 738 cpm; P greater than 0.1) hepatosplenomegaly. Depletion of adherent suppressor cells significantly increased the responses in the group lacking organomegaly (14,028 +/- 1,683 cpm; P less than 0.001) but not in the hepatosplenomegaly group (5,046 +/- 1,830 cpm; P greater than 0.5); this difference in response of nonadherent cells to soluble worm antigenic preparation was statistically significant (P less than 0.02) and not explained by quantitative shifts in OKT8 suppressor cells. Thus, in S. mansoni infection, subjects with hepatosplenomegaly are distinctive in their lack of an immunosuppressive balance of T-lymphocyte subpopulations and in the absence of functional adherent suppressor cells. Defective immunoregulatory mechanisms could be important in the genesis of hepatosplenic disease and its morbid sequelae.
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PMID:Failure of immunosuppressive mechanisms in human Schistosoma mansoni infection with hepatosplenomegaly. 295 55

A 10 year old girl presented with fever, pain, anaemia, hepatosplenomegaly and eosinophilia. No schistosomal ova were found on stool examination. Abdominal ultrasound revealed a mass in front of the portal vein conforming to the shape of an enlarged pancreas. Laparotomy revealed a firm, granular, whitish mass involving the pancreas. Examination of biopsy samples showed granulomata of Schistosoma mansoni in the pancreas, liver and lymph nodes. The patient responded to therapy with oxamniquine.
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PMID:Ultrasonography of pancreatic schistosomiasis: a case report. 309 61

Specific antischistosomal IgG, IgM, and IgE were estimated by ELISA in 117 rural school students before specific treatment with praziquantel monthly for 3-4 months thereafter. IgG and IgM were estimated as percentage of bound antibodies. IgE was estimated by avidin-biotin ELISA (AB-ELISA) as IU/ml using a panel of known IgE standards. Soluble surface Schistosoma mansoni adult worm antigen was used for all estimates. Total IgE was estimated in a smaller group by an ELISA kit. The percentage of specific IgE was calculated. A group of endemic controls (22 students) and non-endemic controls (17 cases) were included. Statistical analysis of results showed the specific immunoglobulins to be significantly reduced 2 months after treatment of the schistosomal cases. These reduced levels, however, were still significantly higher than those of controls. The presence of early hepatosplenomegaly and the co-existence of other parasites had no significant influence on the results. No correlation could be established between the levels of specific antischistosomal IgG, M and E and the intensity of infection. The significance of these results is discussed.
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PMID:Effect of praziquantel on certain immune responses of schistosomal Egyptian patients. I. Changes of specific immunoglobulins. 311 68

Ciclosporin A (CsA), administered subcutaneously as 5 daily injections of 50 mg.kg-1, reduced the numbers of Schistosoma mansoni perfused from MF1 mice at 7 weeks post-infection. The timing of drug administration revealed that the antischistosomal effects were greater when CsA treatment coincided with or was within a few days of infection with the parasite. CsA exerted a clear prophylactic effect, which decreased with time and was virtually abolished by 4 months pre-infection. Adult worms treated in vivo were partially susceptible to CsA. In addition to its antiparasite action, CsA reduced hepatosplenomegaly due to schistosomiasis and diminished the granulomatous inflammatory response of mice to parasite eggs in the liver. The mode of action of CsA is not understood but evidence is presented that supports the proposition that the antiparasite effects are perhaps host-mediated.
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PMID:Prophylactic and therapeutic effects of ciclosporin A in murine Schistosomiasis mansoni: studies on bisexual and unisexual infections and the hepatic inflammatory response. 312 98

Schistosoma mansoni-infected subjects from the Gezira Irrigated Area of Sudan were studied for serum immunoglobulin levels, and specific antibody titres to larval, adult and egg stage antigens, by class and IgG subclass. The 276 subjects were adult chronic cases (frequently exposed male canal cleaners), primary school children, and hospital-referred cases with acute symptoms including hepatosplenomegaly. Chronic untreated cases were compared with a similar group of canal cleaners 3 months after successful chemotherapy with Praziquantel administered at the start of the non-transmission season. All cases, except those previously treated, were egg positive at the time of blood sampling. Data from infected and treated cases were compared with measurements of serum immunoglobulin in a panel of European blood donors. The major findings are as follows: There is a consistently elevated total serum IgG concentration in infected groups which is accounted for mainly by an increased IgG1 subclass (greatest in chronic cases) and by a remarkable 10- to 11-fold increase in IgG4 in the untreated chronically infected group and in the schoolchildren. All infected groups showed high IgG antibody responses to all life cycle stage antigens, and IgM titres were high to adult and egg antigens in untreated canal cleaners. Major differences were evident in the distribution of IgG subclass antibodies between the infected groups: the response to larval and adult antigens is poor or absent in IgG1, IgG2 and IgG3 in untreated chronic infections but is high in IgG4, whereas in acute cases with hepatosplenomegaly and in school-children IgG1, IgG2 and IgG3 antibodies to larval antigens are in high titre but IgG4 and IgM responses to larvae are low or absent, the response in these isotypes being restricted in these cases to adult and egg antigens. Comparing the treated and untreated canal cleaners, although these are separate groups, the data suggest that Praziquantel reduces total serum IgA and IgM levels but has little effect on the raised IgG component except for the IgG4 subclass. The treated chronic cases show a reversal in the ratio of IgG1, IgG2 and IgG3 to IgG4 antibodies to larval and adult antigens compared with the untreated chronic group-the IgG4 response being low by 3 months after treatment and the IgG1, IgG2 and IgG3 being high. These data are discussed in relation to the possible importance of antibody isotype selection in determining host susceptibility to infection, with reference to age, exposure and treatment of the host.
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PMID:Antibody isotypes in human schistosomiasis mansoni. 312 63


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