Hypocholesterolemia in Patients with an Amebic Liver Abscess

BACKGROUND/AIMS: Many parasites induce changes in the lipid profiles of the host. Cholesterol increases the virulence of Entamoeba histolytica in animal models and in vitro culture. This study aimed to determine, in patients with an amebic liver abscess, the correlation between cholesterol and other features, such as the size and number of abscesses, standard hematological and serum chemistry profiles, liver tests, and duration of hospital stay. METHODS: A total of 108 patients with an amebic liver abscess and 140 clinically healthy volunteers were investigated. Cholesterol and triglycerides were measured in the sera. The data from medical observations and laboratory tests were obtained from the clinical records. RESULTS: A total of 93% of patients with an amebic liver abscess showed hypocholesterolemia not related to any of the studied parameters. Liver function tests correlated with the size of the abscess. The most severe cases of amebic liver disease or death were found in patients whose cholesterol levels continued to decrease despite receiving antiamebic treatment and hospital care. CONCLUSIONS: Our results show that the hypocholesterolemia observed in patients with an amebic liver abscess is not related to any of the clinical and laboratory features analyzed. This is the first study relating hypocholesterolemia to severity of hepatic amebiasis.

Leucocyte migration inhibition index responses of patients of amoebic liver abscess to various antigens of Entamoeba histolytica.

The whole amoebic lysate (WAL), Sephadex G-200 eluted fraction-I. (F-I), detergent dissected membrane proteins (DDMP), amoebic membrane glycoprotein (AMG) and amoebal RNA were extracted from E. histolytica. Amoebal RNA recognized 98.21% where as F-I, AMG, DDMP and WAL recognised 92.85, 91.07, 89.28 and 75% of total 56 clinically proven and amoebic serology positive amoebic liver abscess cases respectively. Intensity of recognition of individual fraction i.e., leucocyte migration inhibition index of each fraction was found to be highly significant (P < 0.001) when compared to whole amoebic lysate. This indicate the leucocyte migration inhibition index responses of patients of amoebic liver abscess to various antigenic fractions of E. histolytica with variations.

Correlation between membrane glycoprotein and detergent dissected membrane protein in the assessment of LMIF: a report of 51 ALA cases.

Assessment of 51 amoebic liver abscess cases for leukocyte migration inhibition factor released using membrane glycoprotein and detergent dissected membrane protein (DDMP) of axenic Entamoeba histolytica (NIH:200). Lymphokines release by T lymphocytes in response to purified amoebic membrane glycoprotein (PAMG) against whole amoebic lysate (WAL), dissect out protein against whole amoebic lysate and membrane glycoprotein against dissected protein was tested by leukocyte migration inhibition test on blood samples from proved amoebic liver abscess cases. A significant increase was noted in the release of lymphokines and 100% positivity was observed with both PAMG and DDMP compared to 78% with whole amoebic lysate. The difference between means leukocyte migration indices of the membrane glycoprotein and whole amoebic lysate, detergent dissected protein and whole amoebic lysate with regards to release LMIF were found to be highly significant (P < 0.001), (P < 0.005) respectively. But insignificant difference and very much similarity was noted between the means of membrane glycoprotein and dissect out protein sensitized T lymphocytes with regards to lymphokine release in vitro. This shows the patients had high degree of leukocyte sensitized to pure amoebic membrane glycoprotein and detergent dissected membrane protein compared to whole amoebic lysate. These findings indicate that detergent dissected protein has similar antigenicity with membrane glycoprotein in elicitation cell mediated immune response in amoebic liver abscess cases.

The pathogenesis of raised serum alpha-fetoprotein levels in amoebic and pyogenic hepatic abscesses.

Serum alpha-fetoprotein (AFP) concentrations may be slightly raised in patients with amoebic hepatic abscesses. In an attempt to learn more about the pathogenesis of the raised levels, we studied 74 patients with amoebic and six with pyogenic hepatic abscesses. Serum (AFP) levels were slightly elevated (24-72 ng/ml) on admission in four patients and markedly raised (2000 ng/ml) in one, who had hepatocellular carcinoma in addition to a pyogenic hepatic abscess. The pattern of the early rise in AFP levels could not be determined because these four patients were lost to follow-up. However, serial serum AFP estimations were obtained in 29 patients with a normal value on admission and in none of these did the concentration rise during recovery. Our findings do not support the prevailing hypothesis that regenerating hepatocytes are responsible for the raised serum AFP levels in non-neoplastic hepatic disorders, including hepatic abscesses.

Serum alpha-feto protein in amoebic liver abscess.

Serum alpha-feto protein (AFP) levels were determined using a sensitive and specific ELISA technique in healthy persons (40), patients with amoebic liver abscess (ALA, 70) and hepatocellular carcinoma (HCC, 20). The AFP levels in normal persons ranged between 0 to 20 ng/ml. Most of ALA patients had AFP levels in the normal range; only a small proportion (14.3%) showed elevated levels (range 20-75 ng/ml). Sera from HCC patients had significantly high AFP values in the range of 25 to 340 ng/ml as compared to normal controls and ALA patients. An analysis of serial samples from 10 ALA patients in convalescent phase showed no difference in AFP level during acute and convalescent phase of infection.

Absceso hepatico amibiano: Comportamiento clinico y evolucion / Amebic liver abscess: Clinical findings and evolution

Se presentan 30 casos de absceso hepatico amibiano estudiados en el Hospital Universitario del Valle (HUV) en los anos 1981 y 1982, en los cuales el diagnostico se establecio por gammagrafia hepatica al ingreso. Se discuten los metodos diagnosticos, las modalidades terapeuticas y el comportamiento clinico. En 14 pacientes se llevo a cabo control gammagrafico para determinar el tiempo de resolucion del absceso

Immunodiagnosis of amoebiasis.

Serological studies were done on 127 cases using three different techniques namely indirect haemagglutination (IHA), indirect fluorescent antibody test (IFT) and counter immunoelectrophoresis (CIEP) to detect antiamoebic antibodies. All amoebic liver abscess cases showed significant titre of antibodies by all the three tests used. In the group of patients suffering from amoebic pathology of liver, 90.47 per cent were positive by IHA, 100 per cent by IFT and 85.71 per cent by CIEP respectively. Among amoebic dysentry and amoebic colitis cases 81.81 per cent and 80.64 per cent respectively were positive by IHA. The corresponding figures for IFT were 100 per cent and 74.19 per cent and for CIEP 90.90 per cent and 64.51 per cent respectively. Follow up study showed no significant fall in antibody titre in nine cases studied upto 10 weeks after treatment. Amoebic antigen could be detected in pus from all the nine cases with amoebic liver abscess by CIEP test.

Indirect hemagglutination antibody titers for Entamoeba Histolytica in dried filter paper blood and sera.

Serum and elutates from dried filter paper bloods from 404 patients with and without amebic liver abscess (ALA) were tested for Entamoeba histolytica antibodies by the indirect hemagglutination test. Eighty-nine percent of the sera from patients with ALA were positive (titers greater than or equal to 1 : 128) and 94% of those without ALA negative. Fifty-five percent of the filter paper bloods from ALA patients were positive. Overall agreement was 80% for positives and negatives and the correlation coefficient between the methods showed a linear relationship (r = 0.77). Although the quantity of sera available from dried filter paper bloods is limited and some antibody activity may be lost, the method should be of value in seroepidemiologic studies where venous bloods are not easily obtained.