Parasites and circulating immune complexes at the onset of egg production > 자유게시판

Parasites and circulating immune complexes at the onset of egg production [4], leading to the classical clinical symptoms. The clinical presentation of the reported cases was indicative of such an inflammatory response - patients had a fever >39 and were significantly incapacitated by the clinical disease course. Contrary to these findings, however, inflammatory markers including CRP and BSR were only modestly elevated. At the same time eosinophilia ?a hallmark of invasive helminthic infections ?was markedly elevated. Interestingly, eosinophilia persisted for more than six months prior to normalisation indicating prolonged exposure to helminthic antigen stimulation. This finding may be explained by the fact that praziquantel ?although already administered in our patients during acute infection ?has little activity against the early developmental stages of schistosomal worms and complete cure from all intravascular worms was therefore achieved only after re-administration of praziquantel during the follow up period [7]. Distinct radiographic abnormalities of the lungs in Katayama fever, including patchy pulmonary infiltrates on chest X-ray and single/multiple pulmonary nodules with 2-[(4S)-4,5-Dihydro-4-isopropyl-2-oxazolyl]pyridine ground-glass halos on CT, have been previously described [8-10]. However, radiological alterations in other viscera have been less well described. CT in one of our patients showed radiological alterations of the lung parenchyma consistent with previous reports. In addition, multiple hypodense foci were demonstrated in the liver supporting the hypothesis that Katayama fever representsare more generalized inflammatory response. Whereas these findings are useful from a scientific point of view, the authors are convinced that CT should not be considered as a standard diagnostic examination for patients with suspected Katayama fever, given that the CT features are not pathognomonic of this disease and the risks of exposure to journal.pone.0167038 radiation most likely outweigh the diagnostic benefit. Detailed analysis of coagulation mechanisms including: D-dimer, which indicates an activation of haemostasis and fibrinolysis; the thrombin generation potential, a global in-vitro assay indicating an individual's coagulation potential; and measurement of the MP-TF activity, which reflect a prothrombotic state, showed considerable variability in these cases. One may speculate that the intravascular migration of helminths would result in activation of the coagulation cascade; this was demonstrated by increased levels of D-dimer, a high peak thrombin and a PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/13485127 marked increase of the MP-TF activity in one patient. However, these features were less evident in a second patient, explained either by a less pronounced response in this patient or PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/3081428 that the peak in alterations may have been missed during the referral from another hospital. Despite the intravascular localisation of 4,4,5,5-Tetramethyl-2-(2-methylprop-1-en-1-yl)-1,3,2-dioxaborolane schistosomal worms and the activation of coagulation mechanisms, clinical complications such as thrombotic events are not commonly reported in the context of acute schistosomiasis, consistent with our cases. A better understanding of the underlying mechanisms for this discordance of clinical and laboratory findings may improve our knowledge of the complex interplay between helminth pathogens and the host's response.Conclusion The characterisation of the inflammatory response, coagulation parameters and description of corresponding radiographic findings in our patients may provide helpful information for the diagnostic workup o.