RESUMO
The aim of this investigation was to study the frequency of visceral larva migrans (VLM) granulomas in autopsies at a Children's Reference Hospital in Vitoria, ES Brazil, where anti-Toxocara antibodies are frequently detected in the serum of children admitted at the hospital. Two liver fragments from 310 autopsies of children aged between 1 and 15 years were paraffin embedded, and sections were stained with hematoxylin and eosin and submitted to detection of Toxocara antigens using a rabbit anti-Toxocara serum. Among the 24 cases with granulomatous lesions, ten had eosinophil-rich granulomas positively stained with the anti-Toxocara serum. Some were typical epithelioid granulomas, with a positive reaction in multinucleated giant cells, epithelioid cells, or necrotic debris. The results showed that VLM granulomas are the most frequent granulomatous hepatitis in children in our county. This agrees with the high prevalence of anti-Toxocara antibodies in the serum of children admitted to the Children's Reference Hospital. The 3.2% frequency of liver VLM granulomas in autopsies is less than the 30-39% frequency of positive serology in these children, probably reflecting the low larval burden in infected children.
Assuntos
Granuloma/epidemiologia , Imuno-Histoquímica/métodos , Larva Migrans Visceral/epidemiologia , Hepatopatias/epidemiologia , Toxocara/imunologia , Adolescente , Animais , Autopsia , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Granuloma/imunologia , Granuloma/parasitologia , Humanos , Soros Imunes/imunologia , Lactente , Larva Migrans Visceral/imunologia , Larva Migrans Visceral/patologia , Hepatopatias/imunologia , Hepatopatias/parasitologia , Masculino , Prevalência , Coelhos , Toxocara canis/imunologiaRESUMO
We are reporting 16 cases of toxocariasis found in a two year period. Mean age was 2 years and 9 months. Sex distribution was 1:1. Thirteen (81%) children presented pica, 8 (50%) had pets at home, 10 (62.5%) presented anemia and long standing fever, and all eosinophilic leukocytosis. Fundoscopy was normal in all. Toxocara antibodies (Through ELISA) were increased in all of them. High resolution ultrasonography revealed hypoechoic areas in the liver in 50% of the cases. Therapeutic response was good, the clinical signs and symptoms disappearing at the end of treatment. The eosinophilic leukocytosis, ELISA serum positivity for toxocara and ultrasound findings persisted approximately for a year. Toxocariasis is a common parasitosis in our setting. It must be regarded as the first diagnosis when confronted with eosinophilic leukocytosis and abnormal liver findings by ultrasound.
Assuntos
Larva Migrans Visceral/parasitologia , Hepatopatias Parasitárias/parasitologia , Anticorpos Anti-Helmínticos/análise , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Larva Migrans Visceral/diagnóstico por imagem , Larva Migrans Visceral/patologia , Hepatopatias Parasitárias/diagnóstico por imagem , Hepatopatias Parasitárias/patologia , Masculino , UltrassonografiaRESUMO
We are reporting 16 cases of toxocariasis found in a two year period. Mean age was 2 years and 9 months. Sex distribution was 1:1. Thirteen (81 per cent) children presented pica, 8 (50 per cent) had pets at home, 10 (62.5 per cent presented anemia and long standing fever, and all eosinophilic leukocytosis. Fundoscopy was normal in all. Toxocara antibodies (Through ELISA) were increased in all of them. High resolution ultrasonography revealed hypoechoic areas in the liver in 50 per cent of the cases. Therapeutic response was good, the clinical signs and symptoms disappearing at the end of treatment. The eosinophilic leukocytosis, ELISA serum positivity for toxocara and ultrasound findings persisted approximately for a year. Toxocariasis is a common parasitosis in our setting. It must be regarded as the first diagnosis when confronted with eosinophilic leukocytosis and abnormal liver findings by ultrasound.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Larva Migrans Visceral/complicações , Fígado/parasitologia , Anticorpos Anti-Helmínticos/análise , Seguimentos , Larva Migrans Visceral , Larva Migrans Visceral/patologia , FígadoRESUMO
We are reporting 16 cases of toxocariasis found in a two year period. Mean age was 2 years and 9 months. Sex distribution was 1:1. Thirteen (81 per cent) children presented pica, 8 (50 per cent) had pets at home, 10 (62.5 per cent presented anemia and long standing fever, and all eosinophilic leukocytosis. Fundoscopy was normal in all. Toxocara antibodies (Through ELISA) were increased in all of them. High resolution ultrasonography revealed hypoechoic areas in the liver in 50 per cent of the cases. Therapeutic response was good, the clinical signs and symptoms disappearing at the end of treatment. The eosinophilic leukocytosis, ELISA serum positivity for toxocara and ultrasound findings persisted approximately for a year. Toxocariasis is a common parasitosis in our setting. It must be regarded as the first diagnosis when confronted with eosinophilic leukocytosis and abnormal liver findings by ultrasound. (Au)
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Larva Migrans Visceral/complicações , Fígado/parasitologia , Anticorpos Anti-Helmínticos/análise , Seguimentos , Larva Migrans Visceral/diagnóstico por imagem , Larva Migrans Visceral/patologia , Fígado/diagnóstico por imagemRESUMO
OBJECTIVE: To report rheumatologic or rheumatologic-like manifestations of the visceral larva migrans (VLM) syndrome. METHODS: We carried out a prospective study of patients with VLM seen in a private practice setting in Mexico City between 1990 and 1993. RESULTS: From a population of 600 patients we identified 6 patients (5 women) with VLM. Three patients complained of arthralgia; in 4 a history of migratory cutaneous lesions was elicited, and in one monoarthritis of the right knee was found. One patient had deep edema that suggested thrombophlebitis of the right arm; the man in our series had right testicular swelling during followup. In 2 cases, panniculitis was documented by biopsy and in one, small vessel vasculitis. Four patients had frequent contact with dogs and one with cats; 4 patients frequently ate raw fish. The diagnosis of VLM was confirmed either by the clinical picture, biopsy, or ELISA: CONCLUSION: The spectrum of rheumatological manifestations in VLM may be wider than previously thought.