PubMed · 480017
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G J Mayer. 1979. Pulmonary paragonimiasis.. https://doi.org/10.1016/s0022-3476(79)80088-8
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Fasciola hepatica, a zoonotic liver fluke, can cause disease in humans. Fascioliasis, while common in some tropical and developing countries, is uncommon in the United States. We report two cases of fascioliasis that illustrate both the hepatic and biliary stages of the disease. Clinical features and diagnostic aspects including serologic, radiographic, and histopathologic studies are emphasized. Praziquantel was ineffective in treatment of both patients. Bithionol appears to be an effective treatment for fascioliasis.
Studies relating to the treatment of human taeniasis in the Philippines using Atabrine, bithionol, and mebendazole are reviewed. Cure rates of 93.7% for Atabrine, 85%-100% for bithionol, and 84.62% for mebendazole are reported. Aside from these studies, recent experience in the treatment of Taenia saginata infections at the Department of Parasitology, College of Public Health, is also reported. Twenty patients referred to the department were treated, 3 with bithionol, 17 with praziquantel. Of the 17 patients treated with praziquantel, the study reported cure rates of 47-88.24%.
Liver biopsies from 5 patients with established fascioliasis, before and after bithionol treatment were studied by immunoalkaline phosphatase technique for relative distribution of T cells and their subpopulations. T cell and its subsets are defined for OKT3+ (pan T), OKT4+ (helper/inducer) and OKT8+ (suppressor/cytotoxic) cells by using mouse monoclonal antibodies. Before bithionol treatment, lymphocytic infiltration in all hepatic lesions were predominantly of OKT3+ (pan T) lymphocytes. The distribution of OKT8+ cells was moderate to severe in comparison to the few OKT4+ cells presentation. After bithionol a noticeable regression of the OKT3 lymphocytic in all liver sections. The majority of the lymphocytic infiltration was of the OKT8+ cells, in comparison to the absence of the OKT4+ ones. This may indicate that suppressor/cytotoxic lymphocytes may have a role in the immune regulation of the disease and the mode of action of bithionol is by the accentuation of this immunoregulatory effect.