Impact of toxocariasis in patients with unexplained patchy pulmonary infiltrate in Korea.
Toxocariasis is one of the causes of pulmonary eosinophilic infiltrate that is increasing in Korea. This study was designed to identify the prevalence of toxocara seropositivity in patients with unexplained pulmonary patchy infiltrate and to evaluate associated factors. We evaluated 102 patients with unexplained pulmonary patchy infiltrate on chest computed tomography (CT) scan. As a control set, 116 subjects with normal chest CT were also evaluated. History of allergic disease, drug use, parasitic disease and raw cow liver intake were taken. Blood eosinophil count and total IgE level were measured. Specific serum IgG antibody to Toxocara canis larval antigen and specific IgG antibodies to 4 other parasites were measured by enzyme-linked immunosorbent assay (ELISA). In the infiltrate group, 66.7% subjects were toxocara seropositive whereas 22.4% of the control group were seropositive (p<0.001). In the infiltrate group, patients with a history of eating raw cow liver (odds ratio [OR], 7.8) and patients with eosinophilia (OR, 5.2) had a higher incidence of toxocara seropositivity. Thirty-five percent of toxocara seropositive patients with infiltrate exhibited migrating infiltrate and 48% had decreased infiltrate on the follow-up CT. We recommend that toxocara ELISA should be performed in patients with unexplained pulmonary patchy infiltrate, and that the eating of raw cow liver should be actively discouraged.
Yoon
Young-Soon
YS
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Medical Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Lee
Chang-Hoon
CH
Kang
Young-Ae
YA
Kwon
Sung-Youn
SY
Yoon
Ho Il
HI
Lee
Jae-Ho
JH
Lee
Choon-Taek
CT
D000328:Adult; D000368:Aged; D000818:Animals; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007723:Korea; D007958:Leukocyte Count; D008099:Liver / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D011657:Pulmonary Eosinophilia / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D016036:Seroepidemiologic Studies; D014057:Tomography, X-Ray Computed; D014119:Toxocara / Q000276:immunology; D014120:Toxocariasis / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology
D007073:Immunoglobulin E