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Xiang H, Wang J, Tan D, Xiong Y, Huang P, Shen Y, Xu Y, Gong Z, Hu F, Xu C, Wu J, Liu W, Liu J, Wan H, Hong D, Xie H. The serum IgG antibody level as a biomarker for clinical outcome in patients with cerebral sparganosis after treatment. Front Immunol 2023; 14:1158635. [PMID: 37051247 PMCID: PMC10083495 DOI: 10.3389/fimmu.2023.1158635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
IntroductionCerebral sparganosis is a rare parasitic infection of the brain tissue. The remission of MRI change and clinical symptom has been used to evaluate the therapeutic effect. However, there is no study to correlate the serum IgG antibody level of sparganum to the prognosis of disease after treatment. Methods87 patients with cerebral sparganosis were collected from three medical centers. Clinical symptoms and MRI changes were evaluated at 12 months after initial treatment, and serum IgG antibody level of sparganum was evaluated at 2, 6, and 12 months after treatment. The positive cut-off value was based on 2.1 times the optical density (OD) of negative control. The index value was defined as the sample OD divided by the cut-off value.ResultsAmong the 87 patients after treatment, 71 patients had good clinical outcomes, and 16 had poor clinical outcomes. The area under the curve (AUC) showed that the index value measured at 12 months after treatment had the best prediction effect, with a value of 2.014. In the good-outcome group, the index values were less than 2.014 in all 71 patients, and only 8 patients had mildly enhanced residual lesions on MRI. In the poor-outcome group, the index values were more than 2.014 in all 16 patients, and all patients still showed significantly enhanced lesions on MRI. Compared with poor-outcome patients, only 2 patients with good outcomes had disease recurrence after treatment.DiscussionThis study provided evidence that the serum IgG antibody level of sparganum was a promising biomarker to evaluate the prognosis of patients with cerebral sparganosis after treatment.
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Affiliation(s)
- Haijie Xiang
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jie Wang
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Dandan Tan
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ying Xiong
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Pengcheng Huang
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yu Shen
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yun Xu
- Clinical Department, Jiangxi Provincial Institute of Parasitic Disease, Nanchang, China
| | - Zhihong Gong
- Clinical Department, Jiangxi Provincial Institute of Parasitic Disease, Nanchang, China
| | - Fei Hu
- Clinical Department, Jiangxi Provincial Institute of Parasitic Disease, Nanchang, China
| | - Chunhua Xu
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jie Wu
- Department of Neurosurgery, Guangdong 999 Brain Hospital, Guangzhou, China
| | - Wei Liu
- Department of Outpatient, The Nanchang City First Hospital, Nanchang, China
| | - Junpu Liu
- Clinical Department, Jiangxi Provincial Institute of Parasitic Disease, Nanchang, China
| | - Hui Wan
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Daojun Hong
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Daojun Hong, ; Huiqun Xie,
| | - Huiqun Xie
- Clinical Department, Jiangxi Provincial Institute of Parasitic Disease, Nanchang, China
- *Correspondence: Daojun Hong, ; Huiqun Xie,
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Qiu MH, Qiu MD. [Human plerocercoidosis and sparganosis: II. A historical review on pathology, clinics, epidemiology and control]. Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi 2009; 27:251-260. [PMID: 19852371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This article is the second part of the previous review and summarizes the research advances on pathology, clinical manifestation, diagnosis, treatment, epidemiology, and control of human plerocercoidosis and sparganosis.
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Affiliation(s)
- Ming-Hua Qiu
- Department of Parasitology, School of Medicine, Zhejiang University, Hangzhou 310031, China.
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Rehák M, Kolárová L, Kohnová I, Rehák J, Mohlerová S, Fric E, Chrapek O. [Ocular sparganosis in the Czech Republic--a case report]. Klin Mikrobiol Infekc Lek 2006; 12:161-4, 155. [PMID: 16958022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The authors report a case of 14-year-old boy presented to the Ophthalmologic Department of University Hospital in Olomouc with the diagnosis af acute anterior uveitis. A living parasite has been detected in the anterior chamber in a slit lamp examination. The vitreous and retina remained uninvolved. The acute iridocyclitis associated with parasitic infection is a very rare cause of anterior uveitis in Central Europe. The patient underwent surgical removal of the parasite via paracentesis. The inflammation resolved under the treatment with atropine and dexamethasone drops within a few days. Histopathological examination revealed the parasite as a young larval stage of tapeworm from family Pseudophyllidea (sparganum). Based on the analysis of development cycles of different types of tapeworms and according the literature data on tapeworms found in the Czech Republic genus Spirometra seemed to be the most plausible cause of the patient's disease. As the most probable source of viable parasites authors suspect swallowed water containing tiny infected crustaceans in the dam near the town Olomouc in Moravia.
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Affiliation(s)
- M Rehák
- Department of Ophthalmology Faculty Hospital in Olomouc, Czech Republic.
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Abstract
The diagnosis and management of parasitic diseases of the central nervous system (CNS) is difficult, even for infectious diseases physicians and neurologists. Furthermore, few overviews of the spectrum of causative helminths and clinical syndromes have been published. In the present study, we review the seven most common parasitic diseases of the CNS: (i) cysticercosis, (ii) neuroschistosomiasis, (iii) paragonimiasis, (iv) angiostrongyliasis, (v) hydatid disease, (vi) sparganosis and (vii) gnathostomiasis. Major syndromes of parasitic disease of the CNS and their differential causes are discussed, including: (i) cystic lesions, (ii) enhancing granulomas (with and without creeping subcutaneous eruptions), (iii) eosinophilic meningoencephalitis and (iv) spinal cord disease. Specific risk factors that predispose to these infections are also discussed and particular attention is drawn to the situation in Australia.
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Affiliation(s)
- A J Hughes
- University of Malaya Medical Centre, Kuala Lumpur, Malaysia
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Tan TY, Lui CC, Chen HJ, Liou CW. Cerebral sparganosis: case report. Changgeng Yi Xue Za Zhi 1999; 22:287-92. [PMID: 10493037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
A 19-year-old man visited our hospital following an attack of general tonic-clonic convulsion. Multiple lesions were noted over bilateral frontal areas on brain computed tomography and magnetic resonance images. The diagnosis was confirmed by positive antibody for sparganum using enzyme-linked immunosorbent assay (ELISA). Praziquantel, 2400 mg/d for one month, was prescribed before the antibody test results came out and the treatment failed. Total removal of the lesion and the enclosed parasite cured the patient. Although the features of cerebral sparganosis on brain computed tomography and magnetic resonance images have been previously described, the findings were not specific and the present case exhibited some different patterns including bilateral multiple calcifications and ventricular compression. The significance of the bilateral involvement is not known but the ventricular compression suggests that the disease was in an active stage. Imaging studies appear to only provide some clues for the diagnosis of sparganosis. Bilateral involvement may be seen as in the present case. The final diagnosis depends on pathologic or immunologic examination results. Surgical intervention either using stereotactic techniques or total removal of the lesion is the treatment of choice while antiparasitic agents are ineffective.
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Affiliation(s)
- T Y Tan
- Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, R.O.C
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