[内脏和眼部幼虫迁移:20例成人和儿童的流行病学研究、临床和免疫学结果]。

M Scaglia, S Gatti, A Bruno, C Cevini, G Chichino, B Magnani, R Brustia
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引用次数: 0

摘要

作者报告了20例受内脏迁移幼虫(VLM)和眼部迁移幼虫(OLM)影响的受试者的病例研究。20例患者中,男性11例,女性9例(平均年龄45岁);其中7人是儿童,年龄从1岁到8岁。17例患者表现出可能与VLM综合征相关的临床及生物体液特征;除了有明显提示症状的病例外,在一些患者中发现弓形虫感染表现出很少或轻微的症状,甚至无症状,偶尔由于明显的外周嗜酸性粒细胞增多而被怀疑。3例仅眼部感染。就免疫学而言,在所有20例病例中,血清学检测证实了临床流行病学和/或生物体液学怀疑;特别是ELISA IgG检测显示16例高滴度,而RAST检测显示17例特异性IgE水平显著。从治疗角度看,治疗对象均为临床表现明显的患者:5例患者首选药物为噻苯达唑,仅有2例临床治愈;乙基卡马嗪解决1例临床寄生虫学问题;1例患者仍在接受阿苯达唑治疗。
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[Visceral and ocular Larva migrans: epidemiologic study, clinical and immunologic findings on 20 cases, adult and child].

The authors report a case-study of 20 subjects affected by visceral Larva migrans (VLM) and ocular Larva migrans (OLM). Of the 20 patients, 11 were male, and 9 female (mean age: 45 years); 7 were children, from 1 to 8 years old. Seventeen patients presented clinical and bio-humoral features which could be correlated with VLM syndrome; alongside cases with clearly suggestive symptomatology, in some patients the infection by Toxocara sp. was found to show few or minor symptoms, or even to be asymptomatic and occasionally it was suspected because of a marked peripheral eosinophilia. In 3 cases the infection was exclusively ocular. So far as immunology is concerned, serological tests confirmed in all 20 cases the clinico-epidemiological and/or bio-humoral suspicion; in particular the ELISA IgG test showed high titres in 16 cases, while the RAST showed significant levels of specific IgE in 17 cases. From the therapeutic point of view, the subjects treated were exclusively those presenting a manifest clinical picture: in 5 patients the first choice drug was thiabendazole, with clinical cure in only 2 cases; diethylcarbamazine resolved the clinico-parasitological picture in 1 case; 1 patient is still under treatment with albendazole.

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