Immune disorders in two pediatric patients with Toxocariasis

Authors

  • Concepcion Insua Arregui Universidad de Ciencias Médicas de La Habana. Hospital Pediátrico Universitario "William Soler". La Habana.
  • Jesús Salím Burón Hernández Universidad de Ciencias Médicas de La Habana. Hospital Pediátrico Universitario "William Soler". La Habana.
  • Eric Montero Díaz Universidad de Ciencias Médicas de La Habana. Instituto Cubano de Oftalmología "Ramón Pando Ferrer". La Habana.

Keywords:

Toxocariasis, inmunodeficiencia, zoonosis, trastornos inmunológicos.

Abstract

Introduction: Toxocariasisis is a zoonosis caused by nematodes of the genus
Toxocara. Accidentally, the human being ingests larvae eggs which causes inflammatory reactions. In patients with immunological conditions, the infection is expressed in the most severe form.

Objective: To evaluate the immunological disorders of two patients with Toxocariasis in William Soler Pediatric Hospital.

Case presentation: We present two patients: a 5 years old girl with recurrent respiratory infections and loss of vision on the left eye and a 14 years old boy with recurrent pneumonia, frequent diarrhea and decreased visual acuity in both eyes. After performing a fundus examination to the first patient, leukocoria, granuloma and a marked decrease in visual acuity were found. Quantification of serum immunoglobulins G, A, M were determined by a turbidimetric method, and E was determined by ELISA; B-lymphocyte subpopulations and T lymphocytes and natural killer cells were also determined by flow cytometry and Elisa test, which were positive for Toxocara canis in both cases. In the first patient IgA was 0 g / l (absent), and IgE was 720 IU / mL (elevated). TCD3 + / CD8 + lymphocyte subpopulations (5.57%), and decreased B CD19 (11.06%) were also found. In the second case, IgE was 810 IU / mL (elevated) and the others were normal. TCD3 + / CD8 + lymphocyte subpopulations (4.86%), and NKCD56 (5.04%) were decreased.

Conclusions: Combined T-B immunodeficiency was diagnosed in a patient, and cellular immunodeficiency was diagnosed in the other one. Infections improved in both patients and the loss of visual acuity stopped after treatment with Hebertrans. The torpid evolution and complications corresponded with the immunological deterioration of these patients.

Keywords: Toxocariasis, zoonosis, Immunodeficiency, immunological disorder.

Downloads

Download data is not yet available.

Author Biographies

Concepcion Insua Arregui, Universidad de Ciencias Médicas de La Habana. Hospital Pediátrico Universitario "William Soler". La Habana.

Especialista en Inmunología, Master en enfermedades infecciosas y en Bioética. Profesor Auxiliar.

Jesús Salím Burón Hernández, Universidad de Ciencias Médicas de La Habana. Hospital Pediátrico Universitario "William Soler". La Habana.

Médico Especialista en Inmunología

Profesor Asistente

Eric Montero Díaz, Universidad de Ciencias Médicas de La Habana. Instituto Cubano de Oftalmología "Ramón Pando Ferrer". La Habana.

Médico Especialista en Oftalmología

References

1. Graeff-Teixeira C, Morassutti AL, Kazacos KR. Update on Baylisa scariasis, Highly Pathogenic Zoonotic Infection. Clin Microbiol Rev. [Internet]. 2016 Apr; 29(2):375-99. [Citado 2019 Mar 05]. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/26960940

2. Holland CV. Knowledge gaps in the epidemiology of Toxocara: the enigma remains. Parasitology.[Internet]. 2017 Jan; 144(1):81-94. [Citado 2019 Mar 05]. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/26670118

3. Yoshida A, Hombu A, Wang Z, Maruyama H. Larva migrans syndrome caused byToxocara and Ascaris round worm infections in Japanese patients. Eur J Clin Microbiol Infect Dis. [Internet]. 2016 Sep;35(9):1521-9. [Citado 2019 Mar 05]. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/27272122

4. Boldiš V, Ondriska F, Špitalská E, Reiterová K. Immuno diagnostic approaches for the detection of human toxocarosis. Experimental Parasitology. December 2015; 159:252-258.

5. Moreira GM, Telmo Pde L, Mendonça M, Moreira AN, McBride AJ, Scaini CJ, Conceição FR. Human toxocariasis: current advances in diagnostics, treatment, and interventions. Trenes Parasitol. [Internet]. 2014 Sep; 30(9):456-64. [Citado 2019 Mar 05]. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/25089038

6. Fonte Galindo L, Baldriche Acosta J, Sarracent Pérez J, Hernández Barrios Y, Fong González A. Regulación por helmintos de las respuestas inmunitarias del hospedero. Rev Cubana MedTrop [Internet]. 2016 Abr; 68(1). [Citado 2019 Mar 05]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0375-07602016000100001&lng=es

7. Caraballo L, Zakzuk J. Consideraciones sobre la evolución de la respuesta inmunitaria Th2 y sus posibles relaciones con parasitosis y alergia. Biomédica [Internet]. 2012 Mar; 32(1):145-157. [Citado 2019 Mar 05]. Disponible en: https://www.revistabiomedica.org/index.php/biomedica/article/view/419

8. O’ Relly Noda D, Miña Oliveros L, Pérez Delgado Z, García Hernández C, Menéndez Hernández Y. Toxocariasis ocular. A propósito de un caso. Rev. Med. Electrón. [Internet]. 2018 Dic; 40(6):2097-2107. [Citado 2019 Jul 14]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1684-18242018000602097&lng=es

9. Pak KY, Park SW, Byon IS, Lee JE. Ocular toxocariasis presenting as bilateral scleritis with suspect retinal granuloma in the nerve fiber layer: a case report. BMC Infect Dis. 2016;16:426.

10. Jee D, Woo SJ, Hyon JY, Park KH. Clinical features of ocular toxocariasis in adult Korean patients. Ocul Immunol Inflamm. 2016;24(2):207-16.

11. Chang M, et al. Toxocariasis ocular en el adulto asociada a cirugía de vitrectomía mínimamente invasiva. Revista Cubana de Oftalmología. [Internet]. 2018; 31(1). [Citado 2019 Mar 05]. Disponible en: http://www.revoftalmologia.sld.cu/index.php/oftalmologia/article/view/616

12. Zakzuk J. Inmunorregulación inducida por helmintos: una actualización. Iatreia [Internet]. 2016 June; 29(2):182-193. [Citado 2019 Mar 05]. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0121-07932016000200007&lng

13. Resino S. Inmunología en infecciones de protozoos y helmintos. [libro en internet] EMEI; 2010. [Citado 30 Mar 2017]. Disponible en: http://www.google.com.cu/epidemiologiamolecular.com/inmunologia-infeccionesprotozoos-helmintos/

Published

2019-07-17

How to Cite

1.
Insua Arregui C, Burón Hernández JS, Montero Díaz E. Immune disorders in two pediatric patients with Toxocariasis. Rev haban cienc méd [Internet]. 2019 Jul. 17 [cited 2025 Jul. 3];18(4):634-9. Available from: https://revhabanera.sld.cu/index.php/rhab/article/view/2701

Issue

Section

Clinical and pathological sciences