Clinical and Laboratory Findings among Patients with Toxocariasis in Medic Medical Center, Ho Chi Minh City, Vietnam in 2017-2019
-
Le Dinh Vinh Phuc
,
Cao Ba Loi
,
Huynh Hong Quang
,
Le Duc Vinh
,
Cao Truong Sinh
,
Vu Van Du
,
Que Anh Tram
,
Khong Minh Quang
,
Tang Xuan Hai
,
Tran-Anh Le
Abstract
Background: Human toxocariasis is prevalent in many countries but this disease has been rarely reported from Vietnam. We aimed to investigate the clinical and laboratory findings and assess possible association between these findings in patients with toxocariasis in Vietnam.
Methods: A prospectively study, between October 2017 and June 2019 was performed involving 120 toxocariasis patients at Medic Medical Center, Ho Chi Minh City, Vietnam. The diagnosis of toxocariasis was established based on clinical, laboratory (eosinophilia, raised IgE concentration) and serological (positive Toxocara IgG ELISA test) evaluation as well as the exclusion of other helminthic coinfection.
Results: The most frequently reported manifestation was of skin (n = 93, 77.5%), including urticarial (n= 69, 57.5%) followed by neurologic, gastrointestinal and pulmonary signs/symptoms. Hepatic involvement occurred in 8.3% of the patients. No significant relationship between clinical findings and laboratory parameters was found except the higher values of eosinophil count and IgE concentration among patients with liver involvement. There was a significant relationship between eosinophil count and IgE concentration (r=0.389, P<0.001). Serological findings did not show a correlation with clinical and other laboratory findings.
Conclusion: Our data revealed a wide range of clinical symptoms/signs and a high incidence of skin manifestations in patients with toxocariasis. Eosinophil count and IgE concentration are valuable markers for the evaluation of the disease.
1. Magnaval JF, Glickman LT, Dorchies P, et al. Highlights of human toxocariasis. Korean J Parasitol. 2001;39(1):1–11.
2. Ma G, Holland C V., Wang T, et al. Human toxocariasis. Lancet Infect Dis. 2018;18(1):e14–e24.
3. Iddawela D, Ehambaram K, Atapattu D, et al. Frequency of toxocariasis among patients clinically suspected to have visceral toxocariasis: A retrospective descriptive study in Sri Lanka. J Parasitol Res. 2017;4368659.
4. Elefant G, Shimizu S, Sanchez M, et al. A serological follow-up of toxocariasis patients after chemotherapy based on the detection of IgG, IgA, and IgE antibodies by enzyme-linked immunosorbent assay. J Clin Lab Anal. 2006;20(4):164–72.
5. Beaver PC. Larva migrans. Exp Parasitol. 1956;5:587–621.
6. Łuzna-Lyskov A, Andrzejewska I, Lesicka U, et al. Clinical interpretation of eosinophilia and ELISA values (OD) in toxocarosis. Acta Parasitologica. 2000;45(1):35–39.
7. Magnaval J, Faufingue J, Morassin B, et al. Eosinophil cationic protein, specific IgE and IgG4 in human toxocariasis. J Helminthol. 2006;80(4):417–23.
8. Azam D, Ukpai O, Said A, et al. Temperature and the development and survival of infective Toxocara canis larvae. Parasitol Res. 2012;110(2):649–56.
9. Silver Z, Kaliappan S, Samuel P, et al. Geographical distribution of soil transmitted helminths and the effects of community type in South Asia and South East Asia - A systematic review. PLoS Negl Trop Dis. 2018;12(1):e0006153.
10. Anh N, Thuy D, Hoan D, et al. Levels of Toxocara infections in dogs and cats from urban Vietnam together with associated risk factors for transmission. J Helminthol. 2016;90(4):508–10.
11. Nguyen T, Cheong F, Liew J, et al. Seroprevalence of fascioliasis, toxocariasis, strongyloidiasis and cysticercosis in blood samples diagnosed in Medic Medical Center Laboratory, Ho Chi Minh City, Vietnam in 2012. Parasit Vectors. 2016;9(1):486.
12. Farmer A, Beltran T, Choi YS. Prevalence of Toxocara species infection in the U.S.: Results from the National Health and Nutrition Examination Survey, 2011-2014. PLoS Negl Trop Dis. 2017; 11(7): e0005818.
13. WHO, UNICEF U. Iron deficiency anaemia: assessment, prevention and control, a guide for programme managers. 2001;
14. O’Connell E, Nutman T. Eosinophilia in infectious diseases. Immunol Allergy Clin North Am. 2015;35(3):493–522.
15. Lim J. Toxocariasis of the liver: visceral larva migrans. Abdom Imaging. 2008;33(2):151–6.
16. Pawlowski Z. Toxocariasis in humans: Clinical expression and treatment dilemma. J Helminthol. 2001;75(4):299–305.
17. Rubinsky-Elefant G, Hirata CE, Yamamoto JH, et al. Human toxocariasis: Diagnosis, worldwide seroprevalences and clinical expression of the systemic and ocular forms. Ann Trop Med Parasitol. 2010;104(1):3–23.
18. Wang Y, Hunt K, Nazareth I, et al. Do men consult less than women? An analysis of routinely collected UK general practice data. BMJ Open. 2013;3(8):e003320.
19. Akao N, Ohta N. Toxocariasis in Japan. Parasitol Int. 2007;56(2):87–93.
20. Lee JY, Yang MH, Hwang JH, et al. The prevalence of toxocariasis and diagnostic value of serologic tests in asymptomatic Korean adults. Allergy, Asthma Immunol Res. 2015;7(5):467–475.
21. Jarosz W, Mizgajska-Wiktor H, Kirwan P, et al. Developmental age, physical fitness and Toxocara seroprevalence amongst lower-secondary students living in rural areas contaminated with Toxocara eggs. Parasitology. 2010;137(1):53–63.
22. Soulsby EJL. Nematodes of small intestine. In: Soulsby EJL, editor. Textbook of veterinaty clinical Parasitology. Oxford: Blackwell; 1965. p. 8–31.
23. Luzna-Lyskov A. Toxocarosis in children living in a highly contaminated area. An epidemiological and clinical study. Acta Parasitol. 2000;45:40–42.
24. Taylor M, Keane C, O’Connor P, et al. The expanded spectrum of toxocaral disease. Lancet. 1988;1(8587):692–5.
25. Ain Tiewsoh J, Khurana S, Mewara A, et al. Clinical and laboratory characteristics of patients with toxocariasis encountered at a tertiary care centre in North India. Indian J Med Microbiol. 2018;36(3):432–434.
26. Yoon S-Y, Baek S, Park SY, et al. Clinical course and treatment outcomes of toxocariasis-related eosinophilic disorder. Medicine (Baltimore). 2018;97(37):e12361.
27. Espinoza Y, Huapaya P, Roldán W, et al. Clinical and serological evidence of Toxocara infection in school children from Morrope district, Lambayeque, Peru. Rev Inst Med Trop Sao Paulo. 2008;50(2):101–5.
28. Wiśniewska-Ligier M, Woźniakowska-Gęsicka T, Sobolewska-Dryjańska J, et al. Analysis of the course and treatment of toxocariasis in children-a long-term observation. Parasitol Res. 2012;110(6):2363–71.
29. Gavignet B, Piarroux R, Aubin F, et al. Cutaneous manifestations of human toxocariasis. J Am Acad Dermatol. 2008;59(6):1031–42.
30. Beshear J, Hendley J. Severe pulmonary involvement in visceral larva migrans. Am J Dis Child. 1973; 125(4):599-600.
31. Grieve RB, Stewart VA, Parsons JC. Immunobiology of larval toxocariasis (Toxocara canis): a summay of recent research. In: Lewis W, Maizels RM, editors. Toxocara and Toxocariasis: Clinical, Epidemiological, and Molecular Perspectives. Institute of Biology. London: 1993. p. 117–124.
32. Bowman D, Mika-Grieve M, Grieve R. Circulating excretory-secretory antigen levels and specific antibody responses in mice infected with Toxocara canis. Am J Trop Med Hyg. 1987;36(1):75–82.
33. Magnaval JF, Fabre R, Maurières P, et al. Evaluation of an immunoenzymatic assay detecting specific anti-Toxocara immunoglobulin E for diagnosis and posttreatment follow-up of human toxocariasis. J Clin Microbiol. 1992;30(9):2269–2274.
34. Ahn S, Woo S, Jin Y, et al. Clinical features and course of ocular toxocariasis in adults. PLoS Negl Trop Dis. 2014;8(6):e2938.
35. Desowitz R, Rudoy R, Barnwell J. Antibodies to canine helminth parasites in asthmatic and nonasthmatic children. Int Arch Allergy Appl Immunol. 1981;65(4):361-6.
36. Lee B, Lee J, Kim E, et al. Visceral larva migrans due to Toxocara canis is the most common cause of eosinophilic liver abscess. J Allergy Clin Immunol. 2011;127(2):AB107.
37. Parsons J, Grieve R. Kinetics of liver trapping of infective larvae in murine toxocariasis. J Parasitol. 1990;76(4):529–36.
38. Kayes SG, Omholt PE, Grieve RB. Immune responses of CBA/J mice to graded infections with Toxocara canis. Infect Immun. 1985;48(3):697–703.
39. Jacob C, Pastorino A, Peres B, et al. Clinical and laboratorial features of visceral toxocariasis in infancy. Rev Inst Med Trop Sao Paulo. 1994;36(1):19–26.
40. de Savigny D, Voller A, Woodruff A. Toxocariasis: serological diagnosis by enzyme immunoassay. J Clin Pathol. 1979;32(3):248–288.
41. Anaruma Filho F, Chieffi P, Correa C, et al. Human toxocariasis: incidence among residents in the outskirts of Campinas, State of São Paulo, Brazil. Rev Inst Med Trop Sao Paulo. 2003;45(5):293–4.
42. Hosseini-Safa A, Mousavi S, Bahadoran Bagh Badorani M, et al. Seroepidemiology of toxocariasis in children (5-15 yr Old) referred to the pediatric clinic of Imam Hossein Hospital, Isfahan, Iran. Iran J Parasitol. 2015;10(4):632–7.
43. Uhlíková M, Hübner J, Kolárová L, et al. Immunological studies on human larval toxocarosis. Cent Eur J Public Heal. 1996;4(4):242–5.
44. Rubinsky-Elefant G, Hoshino-Shimizu S, Jacob C, et al. Potential immunological markers for diagnosis and therapeutic assessment of toxocariasis. Rev Inst Med Trop Sao Paulo. 2011;53(2):61–5.
2. Ma G, Holland C V., Wang T, et al. Human toxocariasis. Lancet Infect Dis. 2018;18(1):e14–e24.
3. Iddawela D, Ehambaram K, Atapattu D, et al. Frequency of toxocariasis among patients clinically suspected to have visceral toxocariasis: A retrospective descriptive study in Sri Lanka. J Parasitol Res. 2017;4368659.
4. Elefant G, Shimizu S, Sanchez M, et al. A serological follow-up of toxocariasis patients after chemotherapy based on the detection of IgG, IgA, and IgE antibodies by enzyme-linked immunosorbent assay. J Clin Lab Anal. 2006;20(4):164–72.
5. Beaver PC. Larva migrans. Exp Parasitol. 1956;5:587–621.
6. Łuzna-Lyskov A, Andrzejewska I, Lesicka U, et al. Clinical interpretation of eosinophilia and ELISA values (OD) in toxocarosis. Acta Parasitologica. 2000;45(1):35–39.
7. Magnaval J, Faufingue J, Morassin B, et al. Eosinophil cationic protein, specific IgE and IgG4 in human toxocariasis. J Helminthol. 2006;80(4):417–23.
8. Azam D, Ukpai O, Said A, et al. Temperature and the development and survival of infective Toxocara canis larvae. Parasitol Res. 2012;110(2):649–56.
9. Silver Z, Kaliappan S, Samuel P, et al. Geographical distribution of soil transmitted helminths and the effects of community type in South Asia and South East Asia - A systematic review. PLoS Negl Trop Dis. 2018;12(1):e0006153.
10. Anh N, Thuy D, Hoan D, et al. Levels of Toxocara infections in dogs and cats from urban Vietnam together with associated risk factors for transmission. J Helminthol. 2016;90(4):508–10.
11. Nguyen T, Cheong F, Liew J, et al. Seroprevalence of fascioliasis, toxocariasis, strongyloidiasis and cysticercosis in blood samples diagnosed in Medic Medical Center Laboratory, Ho Chi Minh City, Vietnam in 2012. Parasit Vectors. 2016;9(1):486.
12. Farmer A, Beltran T, Choi YS. Prevalence of Toxocara species infection in the U.S.: Results from the National Health and Nutrition Examination Survey, 2011-2014. PLoS Negl Trop Dis. 2017; 11(7): e0005818.
13. WHO, UNICEF U. Iron deficiency anaemia: assessment, prevention and control, a guide for programme managers. 2001;
14. O’Connell E, Nutman T. Eosinophilia in infectious diseases. Immunol Allergy Clin North Am. 2015;35(3):493–522.
15. Lim J. Toxocariasis of the liver: visceral larva migrans. Abdom Imaging. 2008;33(2):151–6.
16. Pawlowski Z. Toxocariasis in humans: Clinical expression and treatment dilemma. J Helminthol. 2001;75(4):299–305.
17. Rubinsky-Elefant G, Hirata CE, Yamamoto JH, et al. Human toxocariasis: Diagnosis, worldwide seroprevalences and clinical expression of the systemic and ocular forms. Ann Trop Med Parasitol. 2010;104(1):3–23.
18. Wang Y, Hunt K, Nazareth I, et al. Do men consult less than women? An analysis of routinely collected UK general practice data. BMJ Open. 2013;3(8):e003320.
19. Akao N, Ohta N. Toxocariasis in Japan. Parasitol Int. 2007;56(2):87–93.
20. Lee JY, Yang MH, Hwang JH, et al. The prevalence of toxocariasis and diagnostic value of serologic tests in asymptomatic Korean adults. Allergy, Asthma Immunol Res. 2015;7(5):467–475.
21. Jarosz W, Mizgajska-Wiktor H, Kirwan P, et al. Developmental age, physical fitness and Toxocara seroprevalence amongst lower-secondary students living in rural areas contaminated with Toxocara eggs. Parasitology. 2010;137(1):53–63.
22. Soulsby EJL. Nematodes of small intestine. In: Soulsby EJL, editor. Textbook of veterinaty clinical Parasitology. Oxford: Blackwell; 1965. p. 8–31.
23. Luzna-Lyskov A. Toxocarosis in children living in a highly contaminated area. An epidemiological and clinical study. Acta Parasitol. 2000;45:40–42.
24. Taylor M, Keane C, O’Connor P, et al. The expanded spectrum of toxocaral disease. Lancet. 1988;1(8587):692–5.
25. Ain Tiewsoh J, Khurana S, Mewara A, et al. Clinical and laboratory characteristics of patients with toxocariasis encountered at a tertiary care centre in North India. Indian J Med Microbiol. 2018;36(3):432–434.
26. Yoon S-Y, Baek S, Park SY, et al. Clinical course and treatment outcomes of toxocariasis-related eosinophilic disorder. Medicine (Baltimore). 2018;97(37):e12361.
27. Espinoza Y, Huapaya P, Roldán W, et al. Clinical and serological evidence of Toxocara infection in school children from Morrope district, Lambayeque, Peru. Rev Inst Med Trop Sao Paulo. 2008;50(2):101–5.
28. Wiśniewska-Ligier M, Woźniakowska-Gęsicka T, Sobolewska-Dryjańska J, et al. Analysis of the course and treatment of toxocariasis in children-a long-term observation. Parasitol Res. 2012;110(6):2363–71.
29. Gavignet B, Piarroux R, Aubin F, et al. Cutaneous manifestations of human toxocariasis. J Am Acad Dermatol. 2008;59(6):1031–42.
30. Beshear J, Hendley J. Severe pulmonary involvement in visceral larva migrans. Am J Dis Child. 1973; 125(4):599-600.
31. Grieve RB, Stewart VA, Parsons JC. Immunobiology of larval toxocariasis (Toxocara canis): a summay of recent research. In: Lewis W, Maizels RM, editors. Toxocara and Toxocariasis: Clinical, Epidemiological, and Molecular Perspectives. Institute of Biology. London: 1993. p. 117–124.
32. Bowman D, Mika-Grieve M, Grieve R. Circulating excretory-secretory antigen levels and specific antibody responses in mice infected with Toxocara canis. Am J Trop Med Hyg. 1987;36(1):75–82.
33. Magnaval JF, Fabre R, Maurières P, et al. Evaluation of an immunoenzymatic assay detecting specific anti-Toxocara immunoglobulin E for diagnosis and posttreatment follow-up of human toxocariasis. J Clin Microbiol. 1992;30(9):2269–2274.
34. Ahn S, Woo S, Jin Y, et al. Clinical features and course of ocular toxocariasis in adults. PLoS Negl Trop Dis. 2014;8(6):e2938.
35. Desowitz R, Rudoy R, Barnwell J. Antibodies to canine helminth parasites in asthmatic and nonasthmatic children. Int Arch Allergy Appl Immunol. 1981;65(4):361-6.
36. Lee B, Lee J, Kim E, et al. Visceral larva migrans due to Toxocara canis is the most common cause of eosinophilic liver abscess. J Allergy Clin Immunol. 2011;127(2):AB107.
37. Parsons J, Grieve R. Kinetics of liver trapping of infective larvae in murine toxocariasis. J Parasitol. 1990;76(4):529–36.
38. Kayes SG, Omholt PE, Grieve RB. Immune responses of CBA/J mice to graded infections with Toxocara canis. Infect Immun. 1985;48(3):697–703.
39. Jacob C, Pastorino A, Peres B, et al. Clinical and laboratorial features of visceral toxocariasis in infancy. Rev Inst Med Trop Sao Paulo. 1994;36(1):19–26.
40. de Savigny D, Voller A, Woodruff A. Toxocariasis: serological diagnosis by enzyme immunoassay. J Clin Pathol. 1979;32(3):248–288.
41. Anaruma Filho F, Chieffi P, Correa C, et al. Human toxocariasis: incidence among residents in the outskirts of Campinas, State of São Paulo, Brazil. Rev Inst Med Trop Sao Paulo. 2003;45(5):293–4.
42. Hosseini-Safa A, Mousavi S, Bahadoran Bagh Badorani M, et al. Seroepidemiology of toxocariasis in children (5-15 yr Old) referred to the pediatric clinic of Imam Hossein Hospital, Isfahan, Iran. Iran J Parasitol. 2015;10(4):632–7.
43. Uhlíková M, Hübner J, Kolárová L, et al. Immunological studies on human larval toxocarosis. Cent Eur J Public Heal. 1996;4(4):242–5.
44. Rubinsky-Elefant G, Hoshino-Shimizu S, Jacob C, et al. Potential immunological markers for diagnosis and therapeutic assessment of toxocariasis. Rev Inst Med Trop Sao Paulo. 2011;53(2):61–5.
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| Issue | Vol 16 No 4 (2021) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijpa.v16i4.7864 | |
| Keywords | ||
| Toxocariasis Clinical characteristics Eosinophilia IgE concentration Vietnam | ||
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How to Cite
1.
Phuc L, Loi C, Quang H, Vinh L, Sinh C, Du V, Tram Q, Quang K, Hai T, Le T-A. Clinical and Laboratory Findings among Patients with Toxocariasis in Medic Medical Center, Ho Chi Minh City, Vietnam in 2017-2019. Iran J Parasitol. 2021;16(4):538-547.
