Giardia lamblia and chronic gastritis.

One hundred and two patients suffering from giardiasis and/or chronic gastritis were subjected for upper gastrointestinal endoscopy. Purified immune rabbit's serum against Giardia lamblia was used in ELISA and immunoperoxidase (IIP) techniques for detection of Giardia antigen in the stomach. Results showed that out of 70 cases with intestinal giardiasis, 8 (11.4%) by ELISA and 6 (8.6%) by IIP showed gastric giardiasis. Higher percentage of gastric giardiasis (14%) was encountered in cases with both giardiasis and chronic gastritis (50) than in cases with giardiasis alone (5%) but with statistically insignificant difference (P > 0.05). None of the cases with chronic gastritis alone (without giardiasis) was positive for gastric giardiasis. Dyspepsia was the main presenting symptom in cases with gastric giardiasis (P < 0.05) with significant (P < 0.05) association. Helicobacter pylori was encountered in 6 out of 8 cases (75%) with gastric giardiasis (P < 0.05) with significant (P < 0.05) association. Duodenogastric reflux was detected in 4 out of 8 cases (50%). Histopathological changes in antral mucosa were detected in all cases of gastric giardiasis. This study indicates that under abnormal circumstances most probably with decreased gastric acidity, gastric giardiasis can occur in concomitance with intestinal giardiasis. So, one has to search for Giardia in gastric biopsies, particularly those showing chronic atrophic gastritis and H. pylori. Also, one has to be aware of gastric giardiasis as a possible cause of upper gastrointestinal symptoms.

Hydrocele in filarial and non filarial patients. Histopathological, histochemical and ultrastructural studies.

Twenty biopsied material of the testicular tissue were obtained from patients with unilateral hydrocele (eight due to lymphatic filariasis and twelve of idiopathic causes). Twenty biopsies lymphatic were also obtained from the normal unaffected testes and were used as control. The data obtained from histopathological, histochemical and ultrastructural studies revealed alternation in the testicular tissue with hydrocele than in the normal control testis. In the filarial hydrocele 37.5% of the cases showed thickening of the basement membrane and fibrosis with arrest of the spermatogenesis at the level of secondary spermatocytes. In addition, 12.5% showed thickening with interstitial fibrosis. Microfilariae were seen in hydrocele fluid of 3/8 cases (37.5%). In the idiopathic hydrocele 50% of the testicular tissue showed marked collagen deposits and testicular atrophy with fibrosis and thickening of basement membrane. The second 50% of cases showed variable degree of maturation arrests. Explanation for these variations in the pathological and anatomical pictures in both types of hydrocele is suggested. In the filariasis hydrocele it is due to the inflammatory response that may subside and recurrent. In the idiopathic hydrocele, it is due to the irreversible hypoxia caused by the continuous mechanical pressure due to huge amount of hydrocele fluid resulting in irreversible degenerative process with marked fibrosis.

Histo- and immuno-pathological and electron microscopy studies of the splenic red pulps of schistosomiasis mansoni patients.

The histo- and immuno-pathological and electron microscopy (EM.) of the splenic red pulps studies were carried out for schistosomiasis mansoni patients and normal controls. The main pathological processes were interstitial haemorrhages, congestion, proliferation and hyperplasia of the red pulps of the schistosomiasis mansoni patients. The IgG showed marked reaction, moderate with IgA and mild with IgM. The E.M. showed an increase in the size of the different types of the reticular cells particularly those of the nuclear membrane with type II, nuclear degeneration, deposition of fibrin threads, marked fibrosis and phagocytosis and formation of pores at the sinusoidal basement membrane. It was concluded that these pathological processes and the alteration in the immunoregulatory system of the spleen of schistosomiasis mansoni patients reflect the role played and perpetrated in the development of splenomegaly.

Myopathic changes in schistosomal hepatosplenomegaly; histopathological, histochemical and immunopathological studies.

Eighteen patients suffering mainly from schistosomal hepatosplenomegaly (B.H.S.M.) were selected & classified into 3 groups according to the degree of B.H.S.M. Muscle biopsy for histopathological, histochemical and immunopathological studies were taken. The results showed that fatiguability as a symptom was present in all cases but motor weakness was present in four cases. Twelve cases had peripheral neuropathy in the form of glove and stocking hypothesia, while pyramidal tract lesion was present in four cases. Two cases, however, showed both peripheral neuropathy and pyramidal tract lesions. Histopathological and histochemical assessment revealed frank myopathic changes in 14 cases while only one case showed definite neuropathic changes. The remainder cases were inconclusive. Immunopathological examination revealed marked deposition of IgG in 50% of cases, while IgM and IgA showed mild to moderate reactions. It was concluded that muscular changes in schistosomal patients are myopathic in nature and that immunological mechanisms could be considered as a factor in the pathogenesis of this muscular disorder.