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PubMedDate not supplied

Rheumatoid factor and rheumatoid factor isotypes in loiasis with and without accompanying glomerulonephritis.

We have studied the distribution of rheumatoid factor isotypes amongst patients with loiasis with and without accompanying glomerulonephritis to determine the possible role of rheumatoid factor antiglobulins in this disease. Our findings indicate an increase in both immunoglobulin (Ig) G and IgM rheumatoid factor isotypes in patients with filariasis alone as well as in patients with accompanying glomerulonephritis. No association with IgA rheumatoid factor was found. The raised IgG and IgM rheumatoid factor levels did not correlate with corresponding IgG and IgM levels.

Adolescent↗
PubMedDate not supplied

Markers of Loa loa infection in permanent residents of a loiasis endemic area of Gabon.

Different markers of infection were analyzed in 56 permanent residents of a Loa loa endemic village in Gabon. The population was divided into those with parasitological evidence of L. loa infection and those with no history of loiasis over the period of observation (c. 5 years). 26.7% of villagers had L. loa microfilariae, 33.9% had an ocular passage of an adult worm, and 17.8% had calabar oedema. Several other clinical symptoms were present in both groups of individuals, but none was considered to be pathognomonic for L. loa infection. Most of the villagers were polyparasitized, with Plasmodium falciparum and gastrointestinal parasites being particularly prevalent. Mansonella perstans was present in 80% of the villagers and was equally distributed between L. loa microfilaraemic and amicrofilaraemic individuals. Eosinophil levels were elevated in the whole population, and were not significantly different between the groups who were infected and non-infected with L. loa. Polyclonal immunoglobulin (Ig) E levels were high in both the Ambinda villagers and in Gambian serum from patients infected with M. perstans alone and there was no significant difference between the levels of L. loa specific IgG in the Ambinda villagers and the Gambian patients. However, the level of L. loa specific IgG4 was elevated in 75.6% of amicrofilaraemic individuals and could discriminate between most individuals infected with L. loa and those infected with M. perstans, suggesting that this is the best determinant of infection status in the absence of L. loa microfilariae.

Adult↗
PubMed1996

Splenectomy for suspected malignant lymphoma in two patients with loiasis.

Intrasplenic lesions can cause diagnostic difficulties because malignant diseases can be excluded only by histologic examination. We present the cases of two patients with splenic manifestations of loiasis. Both patients had visited central Africa. Several years later, intrasplenic lesions were found during routine examinations (for chest trauma and employment, respectively). Both patients underwent splenectomies because malignant lymphoma was suspected. In both cases, histologic examination of the spleen showed eosinophilic granulomata with multiple Loa loa microfilariae.

Adult↗
PubMed1993

Albendazole in human loiasis: results of a double-blind, placebo-controlled trial.

To assess the filaricidal activity and clinical safety of albendazole in human loiasis, a double-blind, placebo-controlled study was conducted in an endemic area in Benin, Africa. Twenty-three men with microfilaremia (100-30,000/mL) were randomly assigned to receive albendazole (200 mg; n = 11) or placebo (n = 12) twice daily for 21 days; 1 patient from each group withdrew from the study. There were no clinical adverse effects and no observed hepatotoxicity, renal toxicity, or hematologic abnormalities attributable to the drug. In the albendazole group, microfilarial levels began to decrease at day 14 after treatment and by 6 months had fallen to a geometric mean of 20% of pretreatment levels (vs. 84.8% in the placebo group). Blood eosinophil levels and anti-filarial IgG and IgG4 also fell significantly in response to albendazole. Taken together, these data suggest that albendazole has a primary (possibly embryotoxic) effect on the adult parasite, resulting in a slow decrease in microfilaremia.

Adolescent↗
PubMed1994

Effectiveness of diethylcarbamazine in treating loiasis acquired by expatriate visitors to endemic regions: long-term follow-up.

Although successful treatment of loiasis with diethylcarbamazine (DEC) has been reported, little is known about the long-term success rate of therapy or the predisposing factors for treatment failure. To address these questions, 32 patients were followed 2-15 years (median, 4.5) after DEC treatment; all had acquired infection while expatriate visitors to endemic areas of Africa. Using a strict definition of successful treatment, 12 (38%) appeared to be cured after one course of therapy and 5(16%) after two courses. Of the remaining 15 patients, 3 continued to be symptomatic despite more than four courses of treatment. Although 12 of the 17 patients who relapsed did so within 1 year of treatment, several had relatively long asymptomatic periods (2-8 years). There was no predictive difference in clinical or laboratory parameters (including eosinophilia and specific filarial serology) between patients requiring one or more courses of therapy.

Diethylcarbamazine↗
PubMed1996

Microfilarial clearance in loiasis involves elevation of Th1 and Th2 products and emergence of a specific pattern of T-cell populations.

Diethylcarbamazine (DEC) induced clearance of microfilaraemia in loiasis is associated with severe posttreatment reactions. To define the switch from hypo- to hyper-responsiveness associated with DEC treatment, phenotypic alterations of T-lymphocytes, characterized by flow cytometry, and cytokines, determined by enzyme linked immunosorbent assay, were monitored in a microfilaraemic patient. In contrast to reports on onchocerciasis and lymphatic filariases, no elevation of interleukin (IL)-6 and tumour necrosis factor (TNF)-alpha was observed. The most severe side effects coincided with an elevation of interferon (IFN)-gamma on day 3, followed by IL-10, transforming growth factor (TGF)-beta 2 and macrophage inflammatory protein-1 alpha (MIP-1 alpha) peaking on day 5. Phenotypically, T-cell activation markers CD38, CD54 and CD25 were significantly expressed before treatment, with high CD38 expression still existing one year after clearance of microfilaraemia. Treatment-related increases were observed with anti-CD122, anti-HLA-DR and anti-CD69. CD28 was expressed before treatment on almost 100% of CD4+ and CD8+ T cells and dropped to 20% by day 5, reaching again baseline levels on day 21. Furthermore, there emerged 20% TCR alpha beta+/CD3+ T cells and 10% anti-beta V5(c)+ T cells, altogether indicating a specific pattern of T-helper (Th) 1 and Th2 cytokines as well as expansion of certain pauciclonal T-cell populations in response to microfilarial clearance.

Adult↗
PubMed1983

Usefulness of apheresis to extract microfilarias in management of loiasis.

Two patients with loiasis in whom treatment with diethylcarbamazine had to be interrupted because of serious side effects underwent apheresis to extract microfilarias from the blood. After three apheresis sessions the number of microfilarias in the blood had dropped from 8980 to 3412/ml in one patient and from 2950 to 1840/ml in the other. Between 40 and 45 X 10(6) microfilarias were removed from each of the patients. After reduction of the parasitaemia the two patients were given diethylcarbamazine; no appreciable side effects occurred, and the patients were cured.

Adult↗
PubMed1989

Differential recognition of Loa loa antigens by sera of human subjects from a loiasis endemic zone.

Somatic antigens of Loa loa adult worms with molecular weights of 15-180 kDa were identified by Western blot analysis using sera from 3 categories of parasitologically and clinically defined subjects from a loiasis endemic zone. Sera of occult, amicrofilaremic (OL), and 'resistant' individuals with no clinical signs of infection (R) reacted with an antigen of 160 kDa; sera of highly microfilaremic individuals (ML) did not. ML sera strongly reacted with an antigen of 18 kDa which was recognized only weakly or not at all by OL and R sera. At higher dilutions, OL sera only reacted with antigens at 23 and 160 kDa and ML sera reacted with antigens at 18 and 23 kDa, whereas R sera reacted with antigens at 23, 42, 54, 70, 100, and 160 kDa. These data suggested that R sera contained a higher concentration of antibodies which reacted with denatured, nitrocellulose-bound antigens. The IgG4 isotype predominated for all groups of sera, while IgG3 antibody responses were observed only with R sera. IgG1 antibodies were seen in all groups but reacted with fewer antigens than IgG4 antibodies, and no IgG2 antibody responses were detected. Sera against Brugia malayi, Wuchereria bancrofti, Onchocerca volvulus, and Dirofilaria immitis cross-reacted with somatic antigens greater than 70 kDa, whereas none reacted with Loa loa antigens less than 23 kDa.

Animals↗
PubMed1999

Increased frequency of Th2-type cytokine-producing T cells in microfilaremic loiasis.

The frequency of cytokine-producing peripheral blood mononuclear cells was assessed in 28 subjects with microfilaremic loiasis and in 14 amicrofilaremic individuals. In addition, a subgroup of seven microfilaremic individuals coinfected with Plasmodium malariae was evaluated. By using flow cytometry for the intracellular detection of cytokines, a more pronounced T helper (Th)2 cell-type response with the expansion of interleukin (IL)-4, IL-10, and IL-13 expressing CD4+ cells in the microfilaremic compared with the amicrofilaremic group was noted. Expression of IL-5 was equivalent in both groups as was the frequency of Th2-type cytokines expressing CD8+ cells and of Th1-type cytokines (interferon [IFN]-gamma, IL-2, IFN-gamma/IL-2) producing CD4+ and CD8+ cells. Th0-type cytokine-expressing cells, represented by IL-4/IFN-gamma, IL-10/IFN-gamma, and IL-13/IFN-gamma, were equally distributed within groups. Coinfection of P. malariae did not significantly alter the cytokine expression compared with microfilaremic individuals without P. malariae infections. By identifying a large panel of cytokine-producing T cell subpopulations, a Th2-driven immune response in microfilaremic Loa loa patients was noted.

Adult↗
PubMed2004

Human loiasis in a Cameroonian village: a double-blind, placebo-controlled, crossover clinical trial of a three-day albendazole regimen.

Because of the life-threatening, post-treatment reactions that have occurred in patients with loiasis treated with ivermectin, evaluation of a short-course albendazole regimen was undertaken in a Loa-endemic region of Cameroon. In a placebo-controlled, double-blinded, crossover study, 99 subjects with microfilaremia (100-3,3837/mL) were assigned to receive albendazole (400 mg; n = 48) or placebo (n = 51) for three days and were followed for 180 days; at day 180, the groups were crossed over and followed for an additional six months. In those initially receiving albendazole (ALB/PLAC), microfilarial levels decreased significantly by day 90 (P < 0.043), but returned to baseline by day 180. In those receiving albendazole at day 180 (PLAC/ALB), microfilarial levels also decreased following albendazole (P = 0.005). Blood eosinophil and antifilarial IgG levels did not change significantly for either group, although antifilarial IgG4 levels did in the ALB/PLAC group at day 180. Most subjects continued to have elevations in microfilaremia, suggesting that more intensive regimens of albendazole will be necessary to reduce Loa microfilaremia to levels safe enough to allow for ivermectin use.

Adolescent↗
PubMed1991

[Therapeutic trial with ivermectin in loiasis with medium and high microfilaremia].

Treatment with ivermectin at the dosage of 200 microgram/kg in 28 Congolese loiasis patients led to an important decrease of the microfilaremia on day 7, with a reduction of about 90% of the initial parasite load. However, no negativation was observed and, moreover, the parasitemia did not change from day 7 to day 14. Tolerance was quite good, but weak to moderate reactions, linked to the lysis of the microfilariae, were observed in one third of the patients with a microfilaremia greater or equal to 2,500/mm3.

Animals↗
PubMed1990

Clinical manifestations of loiasis in an endemic area in the Congo.

The functional symptomatology of loiasis was studied in 101 Congolese subjects living in a village in a highly endemic area. 27.7% of them were carriers of Loa loa microfilariae. 5.9% were infected with Mansonella perstans. No subjects were found to have dermal microfilariae. In anamnesis, 51.5% of them reported episodes of Calabar swellings, 69.3% history of eyeworm and 10.9% episodes of subcutaneous migration of worms during the last 12 months. Pruritus and secondary dermal lesions were frequently demonstrated in 64.4% and 56.4% of the individuals respectively. Asymptomatic amicrofilaraemic subjects only accounted for 11.9% of the adult population. The study of the life-time risk of eyeworm, also conducted in the Pygmy and Bantu populations of another village, was shown to be useful in epidemiological evaluations.

Adult↗
PubMed1987

Loiasis in an expatriate American child: diagnostic and treatment difficulties.

On the basis of this experience, we recommend the following when faced with possible filariasis in an expatriate from Western Central Africa: (1) Attempt a clinical differentiation between L loa and other filarial infections present in West Africa. It is important to suspect loiasis because this is the only filarial infection that is readily curable; (2) ophthalmologic assessment to diagnose onchocerciasis; (3) if L loa is suspected, thick blood smears should be obtained from midmorning to midafternoon and stained with Giemsa or hematoxylin stains, after a concentration technique is used. Nighttime blood specimens should be obtained if the patient has been in an area where W. bancrofti is prevalent; (4) skin snip biopsies prepared as follows: Bilateral symmetrical skin snips should be taken. In the case of suspected West African filariasis, the pelvic girdle, iliac crest, and back of scapula are thought to have the highest yield. One snip from each of six different sites should be obtained. Each skin snip should be approximately 2 to 3 mm (a cornealoscleral biopsy forceps can be used). Each skin snip is placed in 100 microL (approximately one drop) of normal saline in a flat-bottomed microtiter plate. The plate is incubated at room temperature and checked periodically for 24 hours under a dissecting microscope (X20 to X40). If present, the small worms will be seen wiggling and squirming in the drop of saline; (5) serologic diagnostic methods are most efficient if human filarial antigens are used; (6) if treatment is with diethylcarbamazine, the initial dose should be small.(ABSTRACT TRUNCATED AT 250 WORDS)

Cameroon↗
PubMed1996

Severe adverse reaction risks during mass treatment with ivermectin in loiasis-endemic areas.

The control of onchocerciasis remains a priority in sub-Saharan Africa. Jean-Philippe Chippaux, Michel Boussinesq, Jacques Gardon, Nathalie Gardon-Wendel and Jean-Christophe Ernould here outline studies concerning possible severe adverse reactions to ivermectin used to control onchocerciasis in areas where loiasis is also endemic, and discuss precautions that may be advisable during the implementation of such programmes.

Journal Article↗
PubMed1976

Loiasis. Report of a case and review of the literature.

An adult worm was isolated from the left upper eyelid of a man, eight years after he had left an area in which L loa is endemic. We described his case in order to draw attention to some differences between reported features of the disease in areas in which the worm is endemic and in areas in which it is not.

Adult↗
PubMed1990

The occurrence of loiasis, mansonellosis and wuchereriasis in the Jarawa River Valley, central Nigeria.

In a study to assess the status of filariasis in the Jarawa River Valley of the savanna area of Nigeria, 940 self-selected residents from 10 villages were examined between March 1984 and April 1987. Overall results showed 105 (11.2%) had microfilaraemia and/or clinical signs of filariasis. Sixty-four (6.8%) and 20 (2.1%) persons, respectively, were infected with Mansonella perstans and Loa loa microfilariae (mff). Four of the 28 villagers examined had Wuchereria bancrofti mff in their night blood samples whereas 17 (1.8%) of all residents surveyed had clinical filariasis mainly due to lympho-obstructive manifestations: hydrocele (n = 11, 64.7%); enlargement of the inguinal nodes (n = 8, 47.1%) and elephantiasis (n = 2, 11.8%).

Adolescent↗