Histopathological criteria for the diagnosis of abdominal angiostrongyliasis

Graeff-Teixeira, Carlos; Camillo-Coura, Léa; Lenzi, Henrique Leonel

doi:10.1007/bf00931023

Cited by 60 publications

(61 citation statements)

References 14 publications

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“…Malignancy of lower digestive tract was the initial diagnosis, but appendicular peritonitis could not be ruled out, as it happens in many surgical cases of this disease. Histopathology of the lesions, however, met the criteria for the diagnosis of angiostrongyliasis as suggested by others 6 . These are: eosinophilic infiltration of all layers of the intestinal wall, granulomatous reaction, and eosinophilic necrotic angeitis.…”

Section: Discussionmentioning

confidence: 77%

Human infection by Angiostrongylus costaricensis in Venezuela: first report of a confirmed case

Incani

Caleiras²,

Rodríguez‐Martín³

et al. 2007

Rev. Inst. Med. trop. S. Paulo

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SUMMARYA proven case of human infection caused by Angiostrongylus costaricensis is reported for the first time in Venezuela. The patient was a 57-year-old female surgically operated because of signs of peritonitis with a palpable mass at the lower right quadrant of the abdomen. WBC count reported 16,600 cells/mm 3 , with 46% eosinophils. The tumoral aspect of ileocolic area and peritoneal lymph nodes prompted the resection of a large area of the terminal ileum, cecum, part of the ascending colon and a small part of the jejunum, where a small lesion was found. The pathology showed thickened areas of the intestinal wall with areas of hemorrhage and a perforation of the cecum. Histology showed intense eosinophil infiltration of the whole intestinal wall, granulomas with giant cells and eosinophils. Some of the granuloma surrounded round or oval eggs with content characterized by a large empty area, cells or embryo in the center, and sometimes nematode larvae. A cross section of an adult nematode worm was observed inside a branch of mesenteric artery. The intestinal affected area, the characteristics of the lesions, the presence of eggs in the submucosa with nematode larvae inside, and the observation of a nematode inside a mesenteric artery, makes sufficient criteria for the diagnosis of an infection by Angiostrongylus costaricensis.

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Section: Discussionmentioning

confidence: 77%

Human infection by Angiostrongylus costaricensis in Venezuela: first report of a confirmed case

Incani

Caleiras²,

Rodríguez‐Martín³

et al. 2007

Rev. Inst. Med. trop. S. Paulo

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“…Intestinal lesions, as illustrated in case 1, are associated with the presence of A. costaricensis in the mesenteric arteries, resulting in intestinal ischemia, particularly in the ileocecal segment. The final events of this injury may vary between intestinal infarct, intestinal perforation, formation of pseudotumor or acute appendicitis 2,3 . Otherwise, liver involvement is unusual, with publications restricted to case reports 7,11,16 .…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of AA is confirmed by the identification of eggs, larva or adult worms of A. costaricencis in surgical specimen. In the absence of parasitic elements, the disease can be diagnosed based on three fundamental histopathological findings: a) a massive infiltration of eosinophils in all layers of the intestinal wall; b) a granulomatous reaction; and c) eosinophil vasculitis affecting arteries, veins, lymphatics and capillaries 3 . A presumptive diagnosis may be indicated when serology reveals serum globulins against the parasite 1,2,5,14 .…”

Section: Introductionmentioning

confidence: 99%

Abdominal angiostrongyliasis: report of two cases with different clinical presentations

Rodriguez

Dequi

Peruzzo

et al. 2008

Rev. Inst. Med. trop. S. Paulo

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SUMMARYAbdominal angiostrongyliasis is a sporadic infectious disease caused by the nematode Angiostrongylus costaricensis. It usually presents as acute abdomen, secondary to mesenteric ischemia, and pronounced eosinophilia. In some cases its course is insidious and transient, and the diagnosis is suspicious. The disease is confirmed by the detection of A. costaricensis elements in surgical specimen. The treatment is supportive, with avoidance of antihelminthic administration due to a possible erratic migration followed by worsening of the disease. We report two cases, both with intense eosinophilia and serum IgG-ELISA positive to A. costaricensis. The first case presented ileal perforation and was surgically treated. The second one showed hepatic nodules at ultrasound and was only symptomatically treated, evolving to an apparent protracted resolution. These two cases exemplify different clinical forms of the disease, one of them with liver involvement.

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“…Sera -Samples (n = 26) from patients with histopathological diagnoses of A. costaricensis infections were used as positive controls (PC) (Graeff-Teixeira et al 1991). These patients came from the states of RS, Santa Catarina and Paraná and they were diagnosed after surgical treatment for complicated courses of abdominal disease.…”

Section: Subjects Materials and Methodsmentioning

confidence: 99%

“…105 (7): 914-917, November 2010 Human abdominal angiostrongyliasis (AA) is caused by infection by the intra-arterial nematode Angiostrongylus costaricensis that complete their sexual cycle in rodents. Humans are accidental hosts and the localization of adult worms inside mesenteric arteries leads to the development of inflammatory lesions (Graeff-Teixeira et al 1991). AA has been diagnosed across Central and South America and isolated imported cases have been reported in Europe and the United States.…”

mentioning

confidence: 99%

Use of heterologous antigens for the immunodiagnosis of abdominal angiostrongyliasis by an enzyme-linked immunosorbent assay

Ben

Rodrigues

Agostini

et al. 2010

Mem. Inst. Oswaldo Cruz

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Angiostrongylus costaricensis has a broad geographic distribution spanning from North to South America and the infections of vertebrates with this nematode can result in abdominal complications. Human infections are diagnosed by histological or serological methods because the isolation of larvae from feces is not feasible, as most parasites become trapped in intestinal tissues due to intense eosinophilic inflammation. Because A. costaricensis is difficult to maintain in the laboratory, an immunodiagnostic IgG enzyme-linked immunosorbent assay (ELISA) using antigens from the congeneric Angiostrongylus cantonensis species was evaluated against a panel of serum samples from patients who were histologically diagnosed with A. costaricensis infections. Sera from uninfected individuals and individuals infected with other parasites were used as controls. The sensitivity and specificity of the assay were estimated at 88.4% and 78.7%, respectively. Because the use of purified or cloned antigens has not been established as a reliable diagnostic tool, the use of heterologous antigens may provide a viable alternative for the development of an ELISA-based immunodetection system for the diagnosis of abdominal angiostrongyliasis

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Histopathological criteria for the diagnosis of abdominal angiostrongyliasis

Cited by 60 publications

References 14 publications

Human infection by Angiostrongylus costaricensis in Venezuela: first report of a confirmed case

Human infection by Angiostrongylus costaricensis in Venezuela: first report of a confirmed case

Abdominal angiostrongyliasis: report of two cases with different clinical presentations

Use of heterologous antigens for the immunodiagnosis of abdominal angiostrongyliasis by an enzyme-linked immunosorbent assay

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