SOVREMENNAYA PEDIATRIYA.2016.7(79):37-40; doi 10.15574/SP.2016.79.37 

Assessment of modificated etiotropic and pathogenetic treatment of toxocariasis infestation of children with respiratory system lesions

Dralova O. A., Usachova O. V.

Zaporizhzhia State Medical University, Ukraine

Respiratory system lesions are one of the most frequent manifestations of visceral toxocariasis (registered in 20–50% of patients). However, pathogenetic treatment of children with the respiratory system lesions against the background of this kind of parasitosis is studied poorly.

The aim of our study was to estimate clinical and laboratory efficiency of the implication of the combined medication, which contains silica and lactulose, in the function of toxocariasis infestations pathogenetic treatment in children with respiratory system lesions.

Materials and methods. Under our supervision there were 20 children at the age of 1–17 years (average age – 10±5 years) with respiratory system lesions and the toxocariasis infestations presence. All children received ethiopathogenic treatment with albendazole preparations in a dose of 10 mg/kg for days 10–14, and the combined preparation containing silica and lactulose. General clinical and laboratory examinations were carried out in children, as well as levels detection of 1β, 5, 6 (IL 1β, 5, 6) interleukin before and after treatment (14–21 days). The control group consisted of 20 conditionally healthy children without respiratory system lesions and toxocariasis.

Results. The rash (10 children — 50%), fever (8 (40%)), dyspnoea (3 (15%)) occurred in children with respiratory system lesions before treatment, lymphadenopathy (7 (35%)) and abdominal syndrome (4 (20%)), enlargement of liver (4 (20%)) and spleen (2 (10%)) took place. After treatment applying, on the 14 day demonstrated that singular elements of exanthema and fever (37.3° C) were only in one child. The manifestations of bronchial obstruction syndrome decreased at the end of the first week of treatment. Lymphadenopathy was in 4 children (20%), hepatomegaly — in 2 patients (10%). Before treatment, leukocytosis, ESR acceleration and number increase of band neutrophils were registered. After 21 days of treatment we registered the decrease of leukocytes, ESR and band neutrophils amount to the normal level. Before treatment demonstrated the increase of the IL-6 level against the control group. Thereby, the IL 1β level was much lower than the control level. Before the treatment patients had the lowest levels of IL-5 in the comparison with uninfected by T.canis children. After treatment we received IL-5 figures 2 times higher than before the treatment. Upon that, quick deactivation of pro-inflammatory 1β and 6 interleukins, reaching of IL 1β indicators in conditionally healthy children and IL-6 decrease were among the results of the combined etiopathogenetic therapy.

Conclusions.

1. Respiratory system lesion, as the result of toxocariasis infestation, proceeds more often with exanthema, intoxication and respiratory syndromes.

2. During the laboratory test, general analysis of blood, which was taken before the treatment, showed «inflammatory» changes and the increase of IL-6.

3. After implication of the combined etiopathogenetic therapy with medication, which contains silica and lactulose, there is an increase of the IL-5 level, and the decrease of pro-inflammatory interleukins 1β and 6. This demonstrates the discontinuance of the excessive inflammatory response in the body. This process manifests by rapid leveling of intoxication, abdominal syndromes in the peripheral blood: leukocytosis and ESR.

Key words: children, respiratory system involvement, toxocariasis infestation, clinics, diagnostics, treatment.

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