pulmonary performance and airway reactivity in acute and chronic fascioliasis before and after triclabendazole treatment

ABSTRACT

The pulmonary performance and airway reactivity were evaluated in 16 acute and 12 chronic fascioliasis patients before and after treatment with triclabendazole in a trial to clarify some underlying pulmonary changes which can explain the chest symptomatology that may accompany this intestinal fluke. Before treatment, the maximum voluntary ventilation was impaired in the acute and chronic cases. In the acute stage, the affection was in the small airways [as denoted by lower values of FEF75% compared to control]; while in the chronic stage, the impairment was more generalized including not only the small and large airways [as shown by diminished FVC, FEV1, FEFmax, FEF25%, FEF50% and FEF75%] but also the upper airway [as noticed by lower values of FIVC and FIF50% compared with the corresponding control values]. By individual analysis of the dose response slopes [DRS], 37.5% of acute and 33.3% of chronic cases had bronchial hyperactivity. After triclabendazole treatment and cure of the patients, most of the pulmonary flow rates improved significantly compared with the pretreatment values. Moreover, all cases regained normal bronchial reactivity and the DRS diminished significantly than during fascioliasis infection. It is concluded that, although the fluke doesnot have a cycle in the lung, yet if may have an impact on the pulmonary performance and airway reactivity which subsides greatly after treatment with triclabendazole