Schistosomiasis and colorectal carcinoma in Egypt

This work was carried out to throw light on the etiological importance of schistosomiasis in colorectal and the predictive value of some tumor markers TMs [CEA and CA19-9] in these tumors detection. It included 10 patients with sole colorectal carcinoma [group I], 10 others with colorectal cancer and schistosomiasis [group II], 15 with late intestinal schistosomiasis [group III] and 10 with early schistosomal colitis [group IV], in addition to 10 normal healthy controls [group V]. Results suggested that, it seems time to keep in mind the association between colorectal cancer and S. mansoni particularly in long standing infections. Sole determination of CEA and/or CA19-9 is not enough for diagnosis of colorectal carcinoma. Screening of high risk groups using these markers would require longer follow up along with histopathological study. Furthermore, it could be postulated that the primary role of these TMs in cancer colon and rectum might be assessment of complete tumor excision as well as postoperative surveillance of patients at risk of recurrence

Class I MHC antigens in schistosomal bladder cancer

Twenty unrelated non-smoking males with S.haematobium infection were examined. Ten of these patients had biopsy-proven squamous cell carcinoma of the bladder. Ten healthy controls matched for ethnic origin were also included for comparison. Study groups and controls were all typed for HLA-A, -B and -C using the microdroplet lymphocyte cytotoxicity tet. The study showed no higher frequency between any class I MHC antigen in unrelated cases whether with schistosomal cystitis or with schistosomal bladder cancer

T-Lymphocyte subsets in early schistosomal cancer bladder

T-lymphocytes were claimed to have important role in the immunopathogenesis of schistosomal bladder cancer. In the present study a trial was made to assess T-lymphocyte level and its subsets for diagnosing early bladder cancer in schistosomal patients. The work included 20 cases divided into two equal groups; the first included patients with Schistosoma haematobium while the second included patients with schistosomal bladder cancer. In addition, 10 healthy subjects were also included as controls. In all 3 groups active T-cells count was performed using the Rosette test and the T-lymphocyte subsets were evaluated by the monoclonal antibody test using the immunofluorescent technique. Active T-cells were found to be significantly elevated in both studied groups with significant difference in between. The elevation was more significant in group II. T-helper cells were also statistically elevated in group I and II but with no significant difference. Suppressor cells were only elevated in cases with schistosomal cancer bladder. A significant positive correlation was observed between helper and suppressor cells in the two studied groupos as well as in controls

Effect of injection sclerotherapy on haemodynamic changes in schistosomal hepatic fibrosis

Bleeding oesophageal varices of fifteen adult male Egyptian hepatosplenic schistosomal cases were injected using ethanolamine oleate 5% as a sclerosant. Routine liver functions and laboratory investigations were performed beside rectal, liver biopsies and hepatitis B surface antigen determination. Thereafter, to determine the effect of endoscopic injection sclerotherapy [EIS] on haemodynamics, all patients were subjected to percutaneous transplenic manometry and right-sided cardiac catheterization to measure both the portal venous and pylmonary arterial pressures before and after EIS. Both studied parameters were statistically analysed and were found unaffected by obliteration of the oesophageal varices. This is logical since nothing has been done to relieve the portal pressure. Besides, the effect of gastro-esophageal varices is limited being unable to enlarge beyond certain limits

Injection sclerotherapy and hemostatic changes in hepatic schistosomiasis patients

Fifteen adult male Egyptian hepatosplenic schistosomal patients with bleeding oesophageal varices were studied. Ethanolamine oleate was used as a sclerosant for sclerotherapy. Haemostatic laboratory tests were performed before then one day and two weeks after endoscopic injection sclerotherapy EIS. One day after EIS, tests revealed shortening of blood clotting, bleeding and prothrombin time [PT] times associated with a significant increase in factory VIII while changes in other strudied factors were mild. Platelets showed elevation of their count and improvement of their function. Moreover, fibrinogen levels were increased, euglobulin lysis time was prolonged and there was negative agglutination for fibrinogen degradation products [FDPs] in 40% of cases. Two weeks after EIS, all studied haemostatic parameters returned to their pre-injection levels. Accordingly it is suggested that EIS has both local and systemic transient haemostatic effects

Study of autonomic neuropathy in decompensated schistosomal hepatic fibrosis

The integrity of the autonomic nervous system was investigated in 30 hepatic schistosomiasis patients. Ten normal control of matched age and sex were also included. Patients with advanced hepatic fibrosis showed parasympathetic dysfunction evidenced by abnormalities in the basal heart rate, heart rate responses to valsalva maneuver and to deep breathing as well as size of the pupil in response to intramuscular injection of atropine sulphate. The sympathetic system also showed affection evidenced by abnormalities in blood presence of such abnormalities in the autonomic function tests, none of the patients showed any signs or symptoms of autonomic neuropathy

HLA system and antischistosomal therapy

This study was an attempt to detect any possible relation between HLA antigens and response to antischistosomal chemotherapy. Besides 20 normal healthy controls, the present work included 20 hepatic schistosomiasis patients with active intestinal infection. Cases were given praziquantel in a single oral dose of 30 mg/kg b. wt. All patients [before therapy then 2 weeks after] and controls were subjected to routine laboratory investigations, stool analysis and egg count by Kato thick smear method. Study of HLA-A, -B and -C system was done for controls and cases before treatment by the microdroplet lymphocyte cytotoxicity test. Hepatic schistosomiasis patients showed high frequency of HLA-A28 and B5 antigens. Such cases had a better response to praziquantel therapy. However, a significant association was demonstrated between occurrence of side effects to praziquantel and HLA-B5 positive cases

relation of schistosoma mansoni ova output and splenomegaly in schistosomal hepatic fibrosis

The aim was to study the relation between the intensity of Schistosoma mansoni infection as measured by ova output, the size of the spleen and portal blood pressure. The results showed that there was no significant relation between the egg output and the size of the spleen, and in spite of the detection of some significance in our results, yet it was not an absolute relation. Moreover, no relation could be detected between egg output and portal blood pressure level. However, a significant relation existed between portal pressure measurements and grades 2 and 3 enlarged spleens of Hackett's classification, i.e. it was not an absolute relationship

broad spectrum antihelminthic albendazole in schistosomiasis: a clinical trial

Albendazole, a new broad spectrum benzimidazole drug, was given to 50 schistosomal patients in a daily dose of 600 mg for 6 days. Cure rates of 92% in mansoniasis and 16% in haematobiasis were obtained. The egg reduction rate was 98.3% in mansoniasis and 34.64% in haematobiasis. Clinical and biological tolerance to the drug were excellent. Albendazole is easy to administer, given orally and has minimal side-effects. It is recommended in cases of mansoniasis but not haematobiasis as low cure rates were obtained with the latter

Management of schistosomal colonic polyposis

Schistosomal colonic polyposis of the colon is a common complication of schistosomiasis. Its incidence among schistosomal Egyptian farmers ranges between 5 and 20 percent. Until very recent, medical treatment was ineffective and toxic, while surgery was risky and associated with morbidity. This comparative work was performed to evaluate the efficacy of niridazole, oxamniquine and praxiquantel in chemotherapy of schistosomal colonic polyposis. The study included 90 male patients divided into 3 equal groups. Stool examination, ova counts, sigmoidoscopy, complete blood picture, serum iron and serum proteins were performed before therapy and at 1 and 3 months follow-up periods. The authors recommend the use of oxamniquine in schistosomal colon polyposis in a total dose of 60 mg/kg body weight given over two days. The study showed that niridazole was not effective and toxic while oxamniquine and praziquantel proved effective and produced excellent responses. Biological tolerance was excellent with oxamniquine but much less with praziquantel as cases showed pyrexia, general aches and gastro-intestinal disturbances

Treatment of schistosomiasis with oltipraz given in one single dose

In this study, 152 patients with active S. haematobium and S. mansoni were treated with the relative new non-antimonial oral schistosomicide oltipraz. It was given in one single dose of 25 mg/kg body weight clinical, biological tolerability and drug efficacy were followed up for a period of 12 months. High cures rate ranging between 85 and 96% were obtained. The drug also was well tolerated with no adverse hematological or biochemical effects in schistosomal cases with hepatic fibrosis