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Immigrant Health Study. 7. Foreign workers study: blood parasites. [Abstract]

Khairul Anuar A, Rohela M, Zurainee MN, Abdul Aziz A, Sivanandan S

JUMMEC, 1998;3:63-63.

Lymphatic filariasis is endemic in Asia. The infections persist as a major cause of clinical morbidity and a significant impediment to socioeconomic development. Its prevalence is increasing world wide, largely because of rapid unplanned urbanization in many endemic areas. It is estimated that at least 120 million people are infected. In our study on foreign workers, a total of 241 day time blood samples were collected. The countries represented were Bangladesh (134), Indonesia (103), Pakistan (3) and Myanmar(1). The tests conducted on blood samples were thick blood film for microfilaria and thin blood film for malaria and quantitation of eosinophiles using the Giemsa stain. Out of the 241 blood samples tested, one was positive for Wuchereria bancrofti and one other was positive for malaria (Plasmodium falciparum) each from Bangladesh and Indonesia respectively. As for the blood eosinophiles, 39 (16.18%) blood samples showed high eosinophilia. Fifteen (6.22%) were from Banglandesh and 24 (9.96%) were from Indonesia. The Bangladeshi male who was positive for Witcherrria bamuofti also showed eosinophilia of 22%. We believe that some of these cases with high eosinophilia, may be positive for microfilaria. We may have missed some cases because of the methodology we chose. Lymphatic filariasis is endemic in Bangladesh and Indonesia. In Malaysia W. brancrofti, especially in the cities have been eliminated. However their vectors for the transmission of W. bancrofti is rampant in the cities. With the influx of immigrants with W. bancrofti and in relation to their occupational nature, W. bancrofti may eventually be introduced into the community and change the whole facet of the disease in Malaysia.

Matched MeSH terms: Eosinophilia
Immigrant Health Study. 2. Clinical findings in migrant workers - a pilot study. [Abstract]

Chia YC, McCarthy S

JUMMEC, 1998;3:60-61.

This section only examines the clinical findings and some blood chemistly in these workers. A total of 222 men and 28 women were studied. Their ages ranged from 12 to 57 years, the mean being 30.1 (±7.4). Generally most of the physical examination was normal and no external features of infectious diseases were seen. The mean systolic and diastolic blood pressure was 120 (±13) and 76(±8.7) nun Hg respectively. About 8.4% of the population had elevated blood pressure of 140/90 mmHg or greater. About 12.4% of these man and women were underweight (Body mass index (EMI) less than 19 kg/m2) while 11.2% were either overweight or obese (BMI>25) with the mean being 21.8 (±2.7). Only 3 had BMI greater than 30. Three subjects had a lnitral regurgitation murmur thought to be due to mitral valve prolapse. Four others had tinea cruris, six had insignificant axillary lymph-nodes, five had cervical lymph-nodes of which one was due to carcinoma of the tonsil 30 with shotty inguinal lymph-nodes which was thought to of no pathological significance. Four subjects had crepitations and five had rhonchi in their lungs. A full blood count revealed that 16.65% of the man and 32.1°/o of the women had haemoglobin levels of less than 14gm/dl and 12gm/dl respectively. The most striking abnormality was the high prevalence of eosinophilia. 37% of the subjects had eosinophilia counts of greater than 450/dl. About 19.4% of this study population had fasting blood glucose of greater than 6mmol/l but only 1.3% with fasting blood glucose of greater than 7.8 mmo/l. About 22% of the urine examined revealed pro- teinuria but were otherwise unremarkable for the other parameters. This group of foreign workers was made up of a presumably fairly healthy young population. Attempts to look for infectious disease on physical examination, not surprisingly did not reveal any remarkable findings. It could be that the majority of these subjects already had a examination prior to coming into the country and another one soon after arrival. However an indirect measurement of infectious diseases via the eosinophilic count revealed a high prevalence of parasitic infestations. Attempts to examine the end results of social hardship, be it intrinsic before or appearing after arrival indirectly shoved some degree of suffering. There was a fairly high prevalence of anaemia, especially amongst the women. The body mass index also revealed this population to be generally less obese than other populations. The value of medical check-ups has been debated, especially if it were done as a pre-employment procedure. This pilot study has shown that it is not cost-effective to do physical examination or blood chem- istry and urine analysis in hying to identify infectious diseases in the migrant workers. In the light of the paucity of clinical findings in this pilot study, it would be prudent to review the strategy for examining the health status of migrant workers. Perhaps the physical examination can be dispensed with, and blood andurine analysis beveryfocused and directedin order to maximise the cost- effectiveness of this programme. Certainly the high prevalence of eosinophilia needs further evalua- tion.

Matched MeSH terms: Eosinophilia
Eosinophilic gastroenteritis: Clinical profiles and treatment outcomes, a retrospective study of 18 adult patients in a Singapore Tertiary Hospital

Wong GW, Lim KH, Wan WK, Low SC, Kong SC

Med J Malaysia, 2015 08;70(4):232-7.
PMID: 26358020

BACKGROUND: Eosinophilic gastroenteritis (EG) can mimic symptoms of common gastrointestinal (GI) disorders but responds well to appropriate treatment. Accurate diagnosis is central to effective management. Data on EG in Southeast Asia is lacking. We aim to describe the clinical profiles and treatment outcomes of adult patients with EG in a Singapore Tertiary Hospital.
MATERIALS AND METHODS: This retrospective study involved archival search of patients with GI biopsies that showed eosinophilic infiltration from January 2004 to December 2012. Patients' clinical data from computerised hospital records and clinical notes was reviewed. Diagnostic criteria for EG included presence of GI symptoms with more than 30 eosinophils/high power field on GI biopsies. Patients with secondary causes for eosinophilia were excluded.
RESULTS: Eighteen patients with EG were identified (mean age 52 years; male/female: 11/7). Fifteen patients (83%) had peripheral blood eosinophilia. Seven patients (39%) had atopic conditions. Most common symptoms were diarrhoea and abdominal pain. Small intestine was the most common site involved. Endoscopic finding was non-specific. Ten patients were treated with corticosteroids (nine prednisolone, one budesonide): eight patients (89%) responded clinically to prednisolone but four patients (50%) relapsed following tapering-off of prednisolone and required maintenance dose. One patient each responded to diet elimination and montelukast respectively. Half of the remaining six patients who were treated with proton-pump inhibitors, antispasmodic or antidiarrheal agents still remained symptomatic.
CONCLUSION: Prednisolone is an effective treatment though relapses are common. Small intestine is most commonly involved. EG should be considered in the evaluation of unexplained chronic recurrent GI symptoms.

Matched MeSH terms: Eosinophilia
Granulocyte-Macrophage colony stimulating factor in asthmatic patients infected with respiratory syncytial virus

Abdullah SF

Med J Malaysia, 2021 03;76(2):177-182.
PMID: 33742625

INTRODUCTION: It is estimated that at least 30 to 40% of asthma attacks in adults are related to respiratory infections with viruses. The majority of asthma-related viruses include respiratory syncytial virus (RSV), rhinovirus, and parainfluenza. Inflammatory cytokines are supposed to play a vital role in causing inflammation of the respiratory tract as regulators of proliferation, chemotaxis, and activation of inflammatory cells.
OBJECTIVES: The aim of this study is to assess the role of Granulocyte Macrophage-Colony Stimulating Factor (GMCSF) in asthmatic airway hyper-responsiveness associated with RSV infections.
MATERIALS AND METHODS: Forty five asthmatic cases and 45 healthy individuals were studied in a cross-sectional design. All asthmatics underwent symptom score assessment.GMCSF concentrations in sputum and RSV-IgM/IgG in serum samples were measured for all participants by Enzyme Linked Immuno-Sorbent Assay (ELISA).
RESULTS: The GM-CSF concentration level was significantly higher in asthmatics (270.27± 194.87pg/mL) especially among moderate and severe disease with mean concentration of 197.33±98.47 and 521.08± 310.04 respectively, compared to healthy controls (22.20±21.27 pg/ mL) (p =0.0001). The sputum level of GM-CSF in asthmatics is highly significant associated with positive anti-RSV IgG sera which represents 35/45(77.8%) with mean GM-CSF concentration of (276.99± 86.42) compared with controls at about 31/45 (68.9%) with GM-CSF mean concentration of (22.84±23.47). On the other hand, positive anti-RSV IgM in asthma cases was 8 out of 45(17.8 %) with GM-CSF mean concentration of (307.25± 306.65). Furthermore, GM-CSF sputum level was significantly correlated with eosinophil count especially in moderate and severe asthma.
CONCLUSIONS: This study revealed that GM-CSF level is associated with eosinophilia and indicates asthma severity that might be evident during RSV infection .The distinctive GM-CSF features observed in the sputum from asthmatics with RSV may be useful as a diagnostic methods to help match patients with antibody therapy.

Matched MeSH terms: Eosinophilia
Fulltext Case review of sarcoidosis resembling Sjogren's syndrome

Ahmad Y, Shahril NS, Hussein H, Said MS

J Clin Med Res, 2010 Dec 11;2(6):284-8.
PMID: 22043264 DOI: 10.4021/jocmr482w

We would like to report a case of a 29-year-old male patient who presented with multiple lymphadenopathy and vague symptoms of low grade fever, cough, weight loss, rashes, vomiting, dry eyes and dry mouth. Physical examination revealed submandibular lymphadenopathy, vasculitic rashes over both lower limbs, and parotid gland enlargement. Blood investigations showed mild anemia with leukocytosis, predominantly eosinophilia and high erythrocyte sedimentation rate and C-reactive protein. Computed tomography of the neck, thorax and abdomen showed bilateral submandibular, submental adenopathy, mediastinal and para-aortic lymphadenopathy with generalized reticulonodular densities in both lower lobes. There were hepatomegaly and bilateral enlarged kidneys with renal cyst. Histopathological examination from the cervical lymph node later revealed non-caseating granuloma, consistent of sarcoidosis. Patient responded well to prednisolone 50 mg daily with subsequent reduction in the size of cervical lymphadenopathy and parotid swelling.

KEYWORDS: Lymphadenopathy; Granuloma; Sjogren; Sarcoidosis.

Matched MeSH terms: Eosinophilia