title: Can pleuropulmonary paragonimiasis be cured by only the 1st set of chemotherapy? Treatment outcome and clinical features of recently developed pleuropulmonary paragonimiasis.
abstract: OBJECTIVE
  Most patients with pleuropulmonary paragonimiasis can be cured by the initial single set of Praziquantel (PZQ) treatment. However, several cases have been reported to have unsatisfactory responses to the initial PZQ treatment. The objective of this study was to evaluate the clinical findings of patients with pleuropulmonary paragonimiasis who needed additional PZQ treatment after the 1st set chemotherapy.
  
  
  METHODS
  Thirty-two patients who were diagnosed with pleuropulmonary paragonimiasis at our institution between 2003 and 2008 were retrospectively reviewed.
  
  
  RESULTS
  All patients were treated initially with PZQ for 3 days (1st set chemotherapy). Twenty-four patients (75.0%) showed improvement in respiratory symptoms and pulmonary involvements. However, eight patients (25.0%) suffered from relapsed respiratory symptoms and pleural effusion. For these patients, an additional 2nd set PZQ treatment resulted in the resolution of the symptoms and pulmonary involvements. The characteristics of patients who needed multi-set treatments were as follows; longer duration of respiratory symptoms (single vs multi-set treatment group; 6.67 ± 8.08 vs 17.86 ± 11.84 weeks, p=0.009), higher IgG titer (optical density, O.D.) for Pargonimus westermani (ELISA O.D. for PW, 0.54 ± 0.19 vs 0.88 ± 0.16 O.D., p=0.001) and higher frequency of multiple pulmonary lesions (% of patients with multiple lesions; 16.7% vs 50.0%, p=0.059).
  
  
  CONCLUSIONS
  The patients who had a longer duration of respiratory symptoms, higher ELISA titer for PW and/or multiple pulmonary lesions needed an additional PZQ treatment after the 1st set of chemotherapy. Close follow-up after the initial treatment is necessary especially for such patients.
authors: Department of Internal Medicine, Chonnam National University & Hospital, South Korea.
authors: In-Jae
authors: IJ
authors: Oh
authors: Yu-Il
authors: YI
authors: Kim
authors: Su-Young
authors: SY
authors: Chi
authors: Hee-Jung
authors: HJ
authors: Ban
authors: Yong-Soo
authors: YS
authors: Kwon
authors: Kyu-Sik
authors: KS
authors: Kim
authors: Young-Chul
authors: YC
authors: Kim
authors: Yun-Hyeon
authors: YH
authors: Kim
authors: Hyun Ju
authors: HJ
authors: Seon
authors: Sung-Chul
authors: SC
authors: Lim
authors: Hee-Young
authors: HY
authors: Shin
authors: Soo-Ock
authors: SO
authors: Kim
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008174:Lung Diseases, Parasitic / Q000188:drug therapy* / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D010237:Paragonimiasis / Q000188:drug therapy* / Q000469:parasitology; D010996:Pleural Effusion / Q000188:drug therapy* / Q000469:parasitology; D011223:Praziquantel / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D011223:Praziquantel