Value of proline estimation in diagnosis of hepatic fascioliasis

In the present study, 46 patients with clinical manifestations compatible with those of hepatic fascioliasis [Viz: tender liver, eosinophilia and/or fever] were studied to evaluate the usefulness of estimating proline in plasma, duodenal aspirate and in urine for diagnosis of hepatic fascioliasis. After thorough evaluation the final diagnosis was: hepatic fascioliasis in 12 patients, schistosomiasis in 8 patients, malignant liver in 7 patients, fatty liver in 5 patients, acute viral hepatitis in 5 patients, congestive heart failure in 7 patients and chronic active hepatitis in 2 patients. Plasma proline levels were raised significantly in patients with: fascioliasis [P < 0.01]; malignant liver [P < 0.01]; acute viral hepatitis [P < 0.01] and chronic viral hepatitis [P < 0.01] in comparison with control. While plasma proline levels in patients with schistosomiasis; fatty liver and congestive heart failure were not significantly increased, suggesting that the test to be a good negative one for the exclusion of fascioliasis. Only patients with hepatic fascioliasis showed high proline levels in duodenal aspirate [200 folds of controls, P <.0.01]. Also, 33% of patients with hepatic fascioliasis accompanied with high prolinemia [> 800 umol/L] showed proline in urine while other tested groups showed no proline in urine So, estimation of proline in duodenal aspirate and in urine will, probably prove to be a very useful tests for the differentiation between hepatic fascioliasis and other medical conditions confused with it