[Occurrence of Toxocara spp. eggs in household environment of children with diagnosed toxocariasis in Łódź voivodeship]

Toxocariasis is a zoonosis due to infection of humans by dog or cat roundworm (Toxocara canis, T. cati). Humans become infected by ingestion of infective eggs either from soil, dirty hands, raw fruits and vegetables or larvae from undercooked meat of paratenic hosts. The aim of the study was to evaluate the level of contamination of soil samples from households of children with diagnosed toxocariasis in rural and urban areas of Łódź voivodeship. In the years 2004-2007 toxocariasis was confirmed in 178 patients of the Polish Memorial Hospital in Łódź. The soil samples were collected from 53 courtyards of patients' domiciles. Toxocara spp. eggs were isolated from the samples using flotation technique (Dada 1979). The examinations revealed the high prevalence of ground contamination with Toxocara eggs in both, rural (30.4%) and urban areas (23.3%). The presence of Toxocara eggs in households enlarges the risk of re-infection for children with diagnosed toxocariasis, especially in rural areas where the high level of contamination was detected.

[Estimation of eosinophilia, immunoglobulin E and eosinophilic cationic protein concentration during the treatment of toxocariasis]

Toxocara canis and Toxocara cati do not transform in human organism into a mature form and they circulate reaching various organs and tissues causing characteristic symptoms. Activated eosinophils, which play a significant role in parasitic invasion, contain in their granules eosinophilic cationic protein (ECP) of strong pro-inflammatory activity. The aim of the study was to estimate the concentration of immunoglobulin E, peripheral blood eosinophilia and serum concentration of eosinophilic cationic protein in children treated for toxocariasis and the analysis of their value as the markers of active invasion and the therapy efficacy. The study included 45 children, aged from 3 to 18 years with Toxocara canis infection diagnosed for the first time. The children were diagnosed and treated at the Department of Gastroenterology, in the Outpatient Gastrointestinal and Allergologic Clinic, Institute Polish Mother Health Centre. T. canis larva infection was diagnosed based on serological investigation using immunoenzymatic ELISA test (Bordier Affinity Products, Switzerland). The tests (percentage of eosinophilia in peripheral blood, ECP, IgE) were performed after diagnosis and every 3 months since the beginning of the therapy. In children with toxocariasis its covert form was diagnosed and mebendazole was administered. Among the children with toxocariasis eosinophilia was found in 14 (31.1%) before therapy. Mean percentage of peripheral blood eosinophils was 5.58% in children with toxocariasis. The concentration of IgE was elevated in these children and was significantly higher than in the control group (p=0.002). Mean IgE concentration after 3-and 6-month therapy decreased IgE(I) vs IgE(III) (p=0.01), but it was still higher than normal value. In children with toxocariasis the ECP concentration was 30.19 microg/l before the therapy and was significantly higher than in the control group (p<0.05); after 6 months of the therapy it decreased significantly (p<0.05). Eosinophilic cationic protein and eosinophilia can be the markers of Toxocara canis infection activity. The determination of immunoglobulin E and eosinophilic cationic protein concentration may be useful for toxocariasis therapy monitoring.

[Risk of lithiasis and urolithiasis in children with unspecific inflammatory bowel disease]

Urolithiasis is a disease of a complex, often systemic and not fully unequivocal, etiopathological mechanism, resulting in concrement crystallization The aim of study was the evaluation of frequency of occurrences of crystallization risk states and urolithiasis in children with IBD.

MATERIAL AND METHODS

The study was conducted on 35 children aged between 12 and 18 with confirmed ulcerative colitis (25 children) and Crohn disease (10 children). In all children regiular urine examination and urine inoculation were conducted, as well as stimation of concrement crystallization risk index in a twenty-four hour urine collection. Urinary tract ultrasound as well as evaluation of erythrocytes in urine sediment in phase contrast microscope,have been performed. Control group consisted of 20 children without digestive tract complains.

RESULTS

In 13 (37%) of examined children, urolithiasis occured in family history. The general urine examination revealed in 27 (77%) examined children existence of erytrocyturia of various degree and the evaluation in phase contrast microscope indicated their extraglomucal origin. The ion-creatininal analysis of twenty-four hour urine collection revealed in 29 (82.2%) children risk of oxalate-calcium concrements crystallization and in 6 (17%) children--of oxalate concrements crystallization. USG examination revealed in 4 (11.4%) children existence of single or multiple concrements in urinary system. Analysis of 1 twenty-four hour urine collection indicated the decrease of magnesium ions in 27 (77%) examined children. In control group only in 2 (5.7%) children the risk of occurrence of phosphate-ammonium concrements crystallization, which was significantly lower in examined group (p < 0.01).

CONCLUSIONS

Unspecific intestine inflammations have an influence on the occurrence of crystallization risk states, as well as a fully symptomatic urolithiasis.

[Clinical course of toxocarosis in children]

The aim of the study was to monitor the clinical course of T. canis infection in children with particular consideration of the estimation of infected children's immune system. The study comprised 52 children, aged 3 to 18 years, diagnosed and treated at the I Department of Paediatrics and Gastroenterology, Institute Polish Mother Health Centre, in whom infection with Toxocara canis larva was confirmed with serologic test. The control group included 38 children, aged 3 to 16 years in whom no infection with this parasite was detected in serologic test. In the investigated children subjective and physical examinations were performed, clinical symptoms, changes in organs, haematological, biochemical investigations and selected parameters of humoral and cellular immunity were analysed. In children with toxocarosis most frequently not localized abdominal pain, subfebrile body temperature and generalized lymphadenitis were observed. Significantly higher percentage of eosinophil cells and immunoglobulin E serum concentration with decreased percentage of lymphocytes CD3+, CD4+ and CD4/CD8 ratio were found in the investigated children. Toxocarosis diagnosis is difficult because its clinical symptoms are differentiated and not characteristic, what requires broadening of differential diagnosis concerning numerous entities.