PLASMA-PROTEINS IN CHILDREN WITH TRICHURIS DYSENTERY SYNDROME

Aims-To determine whether in Trichuris trichiura dysentery there is (1 ) evidence of a systemic inflammatory response, (2) evidence that the plasma protein disturbance has special characteristics compared with u ninfected children in the endemic environment. Methods-Three groups of children (age 1.6 to 11.4 years) were studied: 53 cases of trichuris dysentery syndrome (TDS), 16 cases of chronic non-secretory diarrhoea not infected with the parasite (''disease controls'', DC), and 20 asym ptomatic, parasite-free primary schoolchildren (normal controls, NC). C reactive protein, a, antitrypsin, caeruloplasmin, albumin, total glo bulin, fibrinogen, fibronectin, ferritin, and transferrin were measure d on a single occasion for each. The study was thus a cross sectional descriptive survey for group comparison. Plasma viscosity was measured on admission for TDS and DC and repeated after six weeks and six mont hs for TDS. Results-Plasma C reactive protein, alpha, antitrypsin, tot al globulin, fibronectin, and viscosity were significantly higher in T DS than in NC. DC children also had acute phase protein elevations (C reactive protein, caeruloplasmin, viscosity). However, the increase in caeruloplasmin was specific to the DC group while an increase in fibr onectin was specific to the TDS group. Serial measurement of viscosity in TDS showed a modest but significant fall during the six months fol lowing treatment. Conclusions-There is an acute phase response in inte nse trichuriasis and a specific elevation of plasma fibronectin. Plasm a viscosity remains abnormally high six months after treatment, althou gh lower than at diagnosis.