Manifestaciones clinicas y laboratoriales de la uncinariasis / Clinical and laboratory and manifestations of uncinariasis

Los realizaron un esturdio de las principales manifestaciones clinicas y laboratoriales que acompanan la infestacion por uncinarias en 62 ninos lactantes en un periodo de 2 anos y que ingresaron a la Sala Primera del Hospital de Ninos "Dr. Mario Ortiz Suarez" con el diagnostico principal de esta parasitosis. Como manifestacion principal recalcamos la anemia con todo su cortejo sintomatologico de palidez, sudoracion, anorexia, astenia, disnea y choque hipovolemico. Ademas tenemos la desnutricion que acompana casi siempre al cuadro clinico; la diarrea en sus dos formas; aguda o cronica y finalmente los sintomas referentes al sangrado intestinal activo: melena y enterorragia. Todos nuestros pacientes presentaron anemia, algunos de menor grado; pero la mayoria fueron anemias severas, con hemoglobinas por debajo de 7 g/dL y aun hasta por debajo de 2g/dL.

Intestinal nematode infections in children: the pathophysiological price paid.

The mechanism by which small animals such as rodents resist or eliminate nematode parasites requires mucosal inflammation as the final effector of the immune response. The resulting freedom from chronic infection may be worth the price of short-term illness. Putative vaccines which attempt to enhance the natural effect will have to take into account the inflammatory cost to the host. Human helminthiases involve a more stable equilibrium between host and parasite. The medical literature on hookworm disease and clinical ascariasis describes, for the former, some chronic inflammatory effects correlated with worm burden, but for the latter a less quantified or predictable set of detrimental effects. We describe a current, systematic study of the inflammatory response to whipworm infection, in which anaemia, growth retardation and intestinal leakiness are viewed as predictable consequences related to infection intensity. There is evidence for the absence of cell-mediated immunopathology. However, a specific, IgE-mediated local anaphylaxis may, at least partly, mediate the deleterious effects. Increased numbers of mucosal macrophages may also contribute to the chronic, systemic effects through their output of cytokines. Similar attempts to show the mechanisms of pathogenesis and quantify the effects of hookworm disease should be undertaken.

Effect of iron and protein deficiency on the expulsion of Nippostrongylus brasiliensis from the small intestine of the rat.

The relationship between iron deficiency and protein deficiency and infestation of the rat with the nematode Nippostrongylus brasiliensis was investigated. There was a significant delay in the expulsion of N. brasiliensis from the small intestine of both iron deficient and protein deficient animals and those with a combined deficiency of iron and protein. Iron repletion returned the time of worm expulsion to normal and this would appear to be related to iron deficiency per se rather than to anaemia. Antibody initiated damage to worms was normal in the control animals and in animals with nutritional deficiencies. This suggests that the defect in worm expulsion occurs either in the cell-mediated immune system or in one of the other mediators of expulsion. Extrapolation to the human situation has important therapeutic implications in that iron and protein deficiency may play an important role in the perpetuation of helminth infestations. Thus, to be successful antihelminth therapy should be accompanied by iron and protein supplementation.