Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During physical and immunologic investigations on onchocerciasis in 1,298 persons in the Republic of Liberia, the following results were obtained. There is a significant correlation between immune response and Onchocerca volvulus infection detected by a microfilaria-positive skin biopsy. On the other hand, the immune response is not influenced by the number of parasites in the skin, and there is no correlation of the immune response with Onchocerca nodules and with pruritus. There is a high proportion of serologically false-positive and false-negative results, and thus a diagnosis cannot be made simply by establishing evidence for antibodies in one person.
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PMID:Immunologic response in onchocerciasis: relations to microfilaria density in the skin biopsy and to some frequent symptoms. 76 97

Although infection with tissue nematodes is a significant health problem in many parts of the world, such cases are unusual in the continental United States. This report describes a case of Onchocerca volvulus infection, acquired by a 38-year-old female missionary in northern Brazil, that manifested as subcutaneous nodules in the groin and flank two years after the patient's return to the United States. A year previously, a wrong diagnosis of Wuchereria bancrofti was made at biopsy. At that time, treatment with diethylcarbamazine citrate had to be discontinued because of intense pruritus. Examination of a wet saline impression smear of a new biopsy specimen showed the adult worms to have regularly arranged outer annular ridges, which, together with the pruritus after treatment with diethylcarbamazine (a positive Mazzotti test), led to the diagnosis of onchocerciasis. Retreatment with diethylcarbamazine again caused pruritus, but this was tolerated as were subsequent treatments.
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PMID:Subcutaneous nodules as a manifestation of onchocerciasis. A rare condition in the United States. 94 4

An investigation of human infection with Onchocerca volvulus and the resulting clinical disease was carried out for the Nigerian National Onchocerciasis Control Programme between July and August 1989 [corrected]. The survey covered 10.6% of the rural population in 41 savanna villages of central Nigeria. Of the 8451 self-selected individuals examined, 900 (10.6%) had skin microfilariae (Mf). There were differences between villages in both endemicity and intensity of infection, but in general the number of both Mf carriers and cases of clinical onchocerciasis increased with age. The disease in the Mf carriers showed as blindness (0.8%), onchocercal nodules (0.6%), leopard skin (1.6%) and pruritus (2.8%). Of 35 persons with lymphatic complications, 19 had hanging groin, 10 had elephantiasis and six had hydrocoele. Onchocerciasis was mesoendemic in the rocky northern escarpments, and became hypoendemic and sporadic in the southern uplands of sedimentary geological origin.
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PMID:Human onchocerciasis in the lower Jos Plateau, central Nigeria: the prevalence, geographical distribution and epidemiology in Akwanga and Lafia local government areas. 130 6

A double-blind placebo-controlled trial of ivermectin was started in 1987 in 6 villages in southern Sierra Leone. 1625 villagers, 93% of the total population, were surveyed before treatment and allocated at random to the trial. Onchocerciasis was hyperendemic and of moderate intensity in the area. Typical onchocerciasis skin lesions were seen in most cases; the blindness rate was 1.5% and a further 4.3% had visual impairment. Six months after treatment 988 subjects (80%) were reassessed and microfilarial loads in the ivermectin group were found to be 10% of control levels. Additionally, blood eosinophil concentrations were reduced by one-quarter. The severity, but not the prevalence, of skin lesions was significantly reduced in the ivermectin group, with a particularly marked effect on papular eruptions. There had been no reduction in the prevalence of itching, nor had markers of general health shown improvement after ivermectin. Ivermectin is an effective microfilaricidal agent and may improve Onchocerca-related skin lesions after a single dose. However, the lack of obvious benefit to a target population after the first dose of ivermectin may reduce compliance with subsequent doses. This has implications for planned mass treatment initiatives in onchocerciasis endemic regions.
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PMID:A community trial of ivermectin for onchocerciasis in Sierra Leone: clinical and parasitological responses to the initial dose. 206 74

Onchocerca volvulus infection of the residents of two villages in the Upper Atbara River region of Sudan (63.4% prevalence) was found to be medically and socially significant with a remarkable degree of pruritus and dermal pathology present. The severest skin changes, which were often confined to certain areas of the body, were most common in the teenage group (13-19 years). Quantitation of the clinical changes showed that the most severe alterations were present in patients with the lower levels of microfilariae in the skin (0.1-6 mf mg-1) rather than in those with higher levels. Nodules containing adult O. volvulus were found in many individuals, and often in clusters in older patients. Major losses of vision due to O. volvulus were not found, although microfilariae were frequently seen in the cornea and anterior chamber. The commonest corneal change was punctate keratitis, and this was most frequently seen in the teenage group. Trachomatous changes of eyelids and corneas were also seen. The prevalence values of O. volvulus infection in the two villages were significantly increased when, in addition to microfilarial presence in skin biopsies, onchocercal signs such as punctate keratitis, nodule presence and microfilariae in the anterior chamber were taken into consideration. This illustrates the need to consider factors other than skin snip parasitology in obtaining a diagnosis. This study also emphasizes the degree of severity that onchodermatitis can reach and that low levels of dermal microfilariae can be accompanied by very extensive skin changes without any loss of vision. The necessity of considering the severity of skin changes when defining tolerable levels of onchocerciasis in a community is discussed.
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PMID:Severe onchocercal dermatitis in the Ethiopian border region of Sudan. 344 29

The prevalence, intensity and clinical manifestations of onchocerciasis were investigated in three village communities along the Bahr El Arab and its tributaries in Southern Darfur, Western Sudan. Onchocerca volvulus has not been reported from this region before. Over 300 people were examined and the selection of patients was aimed at obtaining a cross-sectional view of the disease at all ages and in both sexes. Prevalence rates were high (67.5%, 28.6% and 32% in Titribi, Radom and Kafia Kingi, respectively). The intensity of infection in young adults was generally about 30 mf/mg, but ranged up to 100 mf/mg. Infections were detected in subjects as young as two years old; about one quarter of those sampled in Titribi had nodules, mostly in the pelvic region. Clinical signs of acute and chronic dermal changes were especially marked in Titribi. This village was located closest to the breeding sites, which appear in the rainy season only. More than a third of those samples had severe pruritus and showed many self-inflicted excoriations. Both anterior and posterior eye segment changes were detected in each community, and cases of onchocercal blindness were attributed to sclerosing keratitis and to optic and chorioretinal atrophy. One case typical of intensely localized disease was seen, where the affliction was unilateral and severe with oedema and pigment changes, but very few microfilariae present. Onchocerciasis appears to be well established in this region and has apparently caused abandonment of some settlements in recent years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Onchocerciasis in Sudan: the Southern Darfur focus. 360 40

Onchocerciasis is found in association with all the main river systems of northern tropical Africa, and there are endemic foci south of the Equator. Heavy and prolonged infection may cause blindness and intense pruritus. The vectors, Simulium damnosum and S. neavei, are also intolerable pests when they swarm. The disease and its vector together cause serious economic loss and are a main cause of the depopulation of river valleys in the savanna lands.The basin of the River Volta, in which the worst endemic area in the world is situated, is considered to be the most favourable area for a study of the problems involved in the large-scale control of onchocerciasis carried by S. damnosum. Mass treatment or prophylaxis are not practicable at present. The clinical condition progresses for many years in the absence of fresh infection, and drugs capable of mass application are needed. However, the first aim is to attack the larval stages of the vector with insecticides. DDT is ideal for this purpose in large, steadily flowing rivers, but a more suitable insecticide and formulation are needed for small, irregularly flowing streams.Research is needed into many aspects of the adult life of S. damnosum, including feeding and resting habits, dry season survival and flight range. One of the main practical problems is prevention of reinfestation of a treated river system.
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PMID:Prospects for the control of onchocerciasis in Africa with special reference to the Volta River basin. 530 98

Initial clinical studies in 32 Senegalese subjects have demonstrated the efficacy of ivermectin in Onchocerca volvulus infection (river blindness). Although O. volvulus microfilariae in skin snips were not reduced in number after single oral doses of 5 micrograms or 10 micrograms/kg body-weight, they were greatly reduced in all subjects after single oral doses of 30 micrograms or 50 micrograms/kg and were eliminated completely in 6 of th 8 subjects who received the 50 micrograms/kg dose. All subjects tolerated the drug well. Transient pruritus which did not require treatment was observed on the day the dose was given in 2 of the 8 subjects after the 30 micrograms/kg dose and in 4 of the 8 who received the 50 micrograms/kg dose. Ivermectin produced no abnormal laboratory results.
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PMID:Efficacy and tolerance of ivermectin in human onchocerciasis. 612 84

Twenty immigrants from Mali and West Senegal were treated in Paris. Onchocerciasis was diagnosed by six skin snips using a Holth punch. Ivermectine was given in a single oral dose: ten patients were given 50 mcg/kg, three were given 75 mcg/kg and seven received 100 mcg/kg. No patients had ocular symptoms. The results were as follows: Pruritus disappeared rapidly in 9 out of 11 patients who itched before treatment. The microfilarial load decreased rapidly, especially in cases treated with 75 mcg/kg and 100 mcg/kg as all patients tested on day 60 were negative. Clinical signs of the Mazzotti reaction and ocular reactions were not observed following the treatment. Pruritus was briefly aggravated in only two patients. No cardiovascular, hematological, hepatic or renal toxicity was noted.
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PMID:[Treatment of human onchocerciasis with ivermectin]. 668 18

Diethylcarbamazine (DEC) therapy for Onchocerca volvulus infection results in frequent ocular and systemic complications, but the pathogenesis of these complications is unclear. Twenty men with O. volvulus infection were treated over a period of six months with DEC given daily for one week and weekly thereafter. Major systemic and ocular complications included proteinuria, severe pruritus, visual field constriction, optic nerve pallor, chorioretinitis, anterior uveitis, and punctate keratitis. Levels of circulating immune complexes (CICs) were increased (greater than 11% [125I]C1q binding) in 14 of the 20 men prior to treatment. Persons with pretreatment C1q binding activity of greater than 30% were at increased risk to develop constriction of visual fields (P less than 0.05) and proteinuria (P less than 0.015). Linear regression analysis revealed a striking correlation between pretreatment levels of CICs and the total number of both systemic and ocular complications (P less than 0.001) and ocular complications alone (P less than 0.005). These results suggest that CICs may be important in the pathogenesis of the delayed systemic and ocular complications following DEC therapy for O. volvulus infection.
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PMID:Ocular and systemic complications of diethylcarbamazine therapy for onchocerciasis: association with circulating immune complexes. 684 23


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