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Syndrome resembling tropical pulmonary eosinophilia but of non-filarial aetiology: serological findings with filarial antigens.

Abstract
Although the tropical pulmonary eosinophilia (TPE) syndrome of filarial aetiology has very distinctive clinical and immunological features, its clinical profile is not unique; other helminths sometimes induce similar presentations. We carefully evaluated 7 individuals with non-filarial TPE-like syndromes and found that serological tests based on detection of 'antifilarial' immunoglobulin (Ig) G, IgG4, and IgE antibodies that are usually considered diagnostic for filarial TPE were equally elevated in patients with non-filarial, TPE-like syndromes and were therefore unhelpful diagnostically. The apparent reasons were immunological hyper-responsiveness of such individuals and the shared (i.e., cross-reactive) antigenicity found in the filarial antigen preparations used routinely for diagnosis. Because appropriate treatment for those different pulmonary eosinophilia conditions requires different drugs and management, and because delay in effective treatment results in significant morbidity in such patients, diagnostic capabilities must be improved by identifying and obtaining unique antigens that can serologically discriminate between filarial TPE and other similar, but non-filarial, pulmonary eosinophilia syndromes.
AuthorsA Rocha, G Dreyer, R W Poindexter, E A Ottesen
JournalTransactions of the Royal Society of Tropical Medicine and Hygiene (Trans R Soc Trop Med Hyg) 1995 Sep-Oct Vol. 89 Issue 5 Pg. 573-5 ISSN: 0035-9203 [Print] England
PMID8560543 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Anthelmintics
  • Antibodies, Helminth
  • Antigens, Helminth
  • Immunoglobulin G
  • Immunoglobulin E
Topics
  • Adult
  • Anthelmintics (therapeutic use)
  • Antibodies, Helminth (analysis)
  • Antigens, Helminth (immunology)
  • Cross Reactions
  • Female
  • Humans
  • Immunoglobulin E (analysis)
  • Immunoglobulin G (analysis)
  • Leukocyte Count
  • Male
  • Middle Aged
  • Pulmonary Eosinophilia (drug therapy, etiology, immunology)

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