الفهرس 
Material and methodsOnly 14 pages are availabe for public view
 |  | from | 138 |  |  |
| | | from | 138 | | |
Abstract
The present work was perfonned on thirty patients, their ages
ranging from 19-49 years with mean 29.7 + 9.9, suffering from active S.
mansoni infection. Ten infected with other parasites as well as ten normal
control individuals were also studied. This work is concerned with
evaluation of circulating anti-SWAP IgG 1 and IgG4 in patients with
active S. mansoni infection before and after PZQ therapy and its
correlation to clinical, laboratory and sonographic data.
For each case, complete history taking, clinical examination as well
as the following laboratory investigations were performed:
1- Direct stool examination for detection of schistosomal ova and
other parasitological infections.
2- Counting eggs in stool samples using Kato thick smear technique.
3- Complete blood picture.
4- Liver function tests.
5- Sigmoidoscopy was done for detection of’S. mansoni eggs on all
patients.
6- Abdominal ultrasonography: for detection ofliver and splenic sizes
and degree of periportal fibrosis.
7_Detection of circulating antischistosomal IgG 1 and IgG4 by ELISA
technique using S. mansoni SWAP which was previously prepared.
Praziquantel was given in a single oral dose of 40mg/kg body
weight. ELSIA was carried out three months after PZQ therapy.
Stool examination were repeated also, 3 months after therapy.
SUMMARY AND CONCLUSION
The following data were collected, analyzed and tabulated:
1~The main complaints of the patients were abdominal discomfort,
pain, tenesmus and bleeding per rectum. After therapy there is a
progressive decrease in these complaints
2- The anti-SWAP IgG 1 and IgG4 were significantly higher in
patients with active S. mansoni infection than control.
3- A progressive decrease in the level of circulating anti-SWAP IgG 1
after treatment and this decrease was significant.
4- A decrease in the level of IgG4 three months after treatment.
5- A decrease in the egg count after therapy.
6- No significant difference in the levels ofIgG 1 or IgG4 was noticed
between male and female patients before and after treatment.
7- No significant difference in the level ofIgGI or IgG4 was noticed
between patients having GIT manifestation and organomegalic
patients and/or asymptomatic patient.
8- No significant difference in the level ofIgGl or IgG4 was noticed
between patients with grade (0), graele (1) and grade (II) periportal
fibrosis.
9- The sensitivity of ELISA in detection of IgGl was 73.3% and
specificity was 80% while its sensitivity and specificity to IgG4
was 80%.
10- Enlarged liver and/or spleen, periportal fibrosis, and dilated P.V
detected by ultrasonography are more in schistosomiasis
patients than control group.
11- There was no significant difference between hemafological
parameters with schistosomiasis in patients and control groups.
12- There was no significant difference between liver functions in
patients and control groups.
060 100 &0
SUMMARY AND CONCLUSION
from previously mentioned results, the following conclusions were:
1- ELISA test was a sensitive and specific test for measuring IgG 1
and IgG4.
2- Estimation of anti-SWAP IgG 1 and IgG4 is a diagnostic for active
infection.
3- Significant reduction of anti-SWAP IgG 1 and IgG4 after treatment
was noted.
4- Detection of anti-SWAP IgG 1 and IgG4 is considered as one of the
parameter of evaluating cure of schistosomiasis.
5- Follow up of specific anti-schistosomal IgGI and IgG4 may be
useful for assessment of the efficacy ofPZQ therapy.