Okinawa Prefecture is an endemic area of Strongyloides stercoralis infection. Since treat ment of this infection remains unsatisfactory, we evaluated the efficacy of ivermectin. Twenty three patients were treated with a single oral dose of ivermectin (mean ± SD, 105.5 ± 20.8 meg/ kg of body weight), followed by a second dose two weeks later. The rate of cure was 85.7% at 2 weeks after the first treatment, and 90.5% at 2 weeks after the second treatment. Side effects occurred in 2 patients (8.7%), but they were mild and transient. The results indicate that ivermectin might be useful and relatively safe for the therapy of Strongyloides stercoralis infection as an alternative to thiabendazole or mebendazole. (Internal Medicine 31: 310-312, 1992)

No abstract

An interesting case of hereditary angioedema in a 26-year-old female is reported, with a finding of transient effusion of fluid into the peritoneal cavity during the attacks. The patient suffered from recurrent abdominal pain for several years, but no family members had any similar symptoms. In spite of repeated hospital admissions and many examinations, accurate diagnosis was not made until the most recent admission. The recognition of hereditary angioedema as a cause of acute and/or recurrent abdominal pain may avoid useless invasive procedures and lead to adequate treatment in other similar cases.

We reported the efficacy of albendazole (ABZ) for the treatment of 27 patients with strongyloidiasis. Twenty-seven patients, 23 males and 4 females, received 200 mg of ABZ one hour before breakfast and supper for 3 days and this treatment was repeated 2 weeks later. The following results were obtained: 1) The eradication rate at 2 weeks after the initial treatment was 70.4% (19 of 27 patients) and 2 weeks after the second course was 66.7% (16 of 24 patients). 2) One patients (3.7%) complained of abdominal pain after the first treatment. Four patients (14.8%) complained of headache (n = 2), nausea (n = 1) and exanthema (n = 1) after the second treatment. But all symptoms were mild and required no treatment and subsided in a few days. 3) Positive rate of HTLV-1 antibody was 45.8% in the patients. As described above, side effects occurred in some cases, although they were mild and transient. From these results, it can be concluded that on increased dose of ABZ could be much more favorable for the treatment of strongyloidiasis.

We treated 245 strongyloidiasis patients with 7 schedules of mebendazole (MBZ) and obtained the eradication rates at 8 months to 2 years after the final treatment as described follows; MBZ (100 mg) was given twice a day orally. [Square bracket shows incidence of liver disfunction.] 1) The eradication rates at 2 years after single course of MBZ therapy for 28 days and a combination therapy (thiabendazole 500 mg powder form three times daily for 5 days followed by MBZ in powder form for 9 days, repeated once) were 93.8% (15 of 16 patients), [71.4%] and 100.0% (16/16), [50.0%]. 2) The eradication rates at 8-15 months after using MBZ alone in varying dosages were as follows: a) MBZ powder was administered for 5 days and was then repeated 1, 3 and 4 weeks later: 87.1 (27/31), [51.1%]. b) MBZ powder was given for 5 days and repeated 1 and 3 weeks later: 100.0% (7/7), [30.8%]. c) MBZ powder was administered for 4 days and repeated 1, 3 and 4 weeks later: 96.3% (26/27), [57.8%]. d) MBZ in tablet form was given for 4 days and repeated 1, 3 and 4 weeks later: 89.6% (43/48). [66.2%]. e) MBZ in tablet form was administered for 4 days and repeated 1 week later: 69.2% (9/13), [25.0%]. As described above, although the incidence of liver disfunction in the 4-day with 2-course therapy was lower than the other schedules, the eradication rate was lower. From these results, MBZ should be given to strongylodiasis patient for 4 days and repeated once, or for 3 days and repeated two or three times with 1 to 2 weeks intervals.