Can Pleuropulmonary Paragonimiasis be Cured by Only the 1st Set of Chemotherapy? Treatment Outcome and Clinical Features of Recently Developed Pleuropulmonary Paragonimiasis
Purpose 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...
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Published in | Internal Medicine Vol. 50; no. 13; pp. 1365 - 1370 |
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Abstract | Purpose 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. Patients and 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). Conclusion 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. |
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AbstractList | Purpose 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. Patients and 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). Conclusion 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. PURPOSEMost 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.PATIENTS AND METHODSThirty-two patients who were diagnosed with pleuropulmonary paragonimiasis at our institution between 2003 and 2008 were retrospectively reviewed.RESULTSAll 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).CONCLUSIONThe 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. 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. Thirty-two patients who were diagnosed with pleuropulmonary paragonimiasis at our institution between 2003 and 2008 were retrospectively reviewed. 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). 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. |
Author | Lim, Sung-Chul Oh, In-Jae Kim, Young-Chul Ban, Hee-Jung Kim, Kyu-Sik Kim, Yun-Hyeon Kwon, Yong-Soo Shin, Hee-Young Chi, Su-Young Seon, Hyun Ju Kim, Soo-Ock Kim, Yu-Il |
Author_xml | – sequence: 1 fullname: Oh, In-Jae organization: Department of Internal Medicine, Chonnam National University & Hospital, South Korea – sequence: 2 fullname: Kim, Yu-Il organization: Department of Internal Medicine, Chonnam National University & Hospital, South Korea – sequence: 3 fullname: Chi, Su-Young organization: Department of Internal Medicine, Chonnam National University & Hospital, South Korea – sequence: 4 fullname: Ban, Hee-Jung organization: Department of Internal Medicine, Chonnam National University & Hospital, South Korea – sequence: 5 fullname: Kwon, Yong-Soo organization: Department of Internal Medicine, Chonnam National University & Hospital, South Korea – sequence: 6 fullname: Kim, Kyu-Sik organization: Department of Internal Medicine, Chonnam National University & Hospital, South Korea – sequence: 7 fullname: Kim, Young-Chul organization: Department of Internal Medicine, Chonnam National University & Hospital, South Korea – sequence: 8 fullname: Kim, Yun-Hyeon organization: Department of Radiology, Chonnam National University & Hospital, South Korea – sequence: 9 fullname: Seon, Hyun Ju organization: Department of Radiology, Chonnam National University & Hospital, South Korea – sequence: 10 fullname: Lim, Sung-Chul organization: Department of Internal Medicine, Chonnam National University & Hospital, South Korea – sequence: 11 fullname: Shin, Hee-Young organization: Clinical Trial Center, Chonnam National University & Hospital, South Korea – sequence: 12 fullname: Kim, Soo-Ock organization: Department of Internal Medicine, Seonam University College of Medicine, Korea |
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References_xml | – volume: 128 start-page: 534 issn: 0003-0805 year: 1983 ident: 6 publication-title: Am Rev Respir Dis doi: 10.1164/arrd.1983.128.3.534 contributor: fullname: Johnson RJ, Johnson JR – ident: 18 – volume: 159 start-page: 39 issn: 0361-803X year: 1992 ident: 9 publication-title: AJR Am J Roentgenol doi: 10.2214/ajr.159.1.1609718 contributor: fullname: Im JG, Whang HY, Kim WS, Han MC, Sh – volume: 35 start-page: 87 issn: 1058-4838 year: 2002 ident: 4 publication-title: Clin Infect Dis doi: 10.1086/340709 contributor: fullname: Meehan AM, Virk A, Swanson K, Poesc – volume: 43 start-page: 427 issn: 1343-3490 issue: 7 year: 2005 ident: 12 publication-title: Nihon Kokyuki Gakkai Zasshi contributor: fullname: SUMITANI MITSUHIRO – volume: 24 start-page: 177 issn: 0023-4001 year: 1986 ident: 22 publication-title: Kisaengchunghak Chapchi doi: 10.3347/kjp.1986.24.2.177 contributor: fullname: Choi WY, Yoo JE, Nam HW, Choi HR – volume: 49 start-page: e55 issn: 1058-4838 year: 2009 ident: 17 publication-title: Clin Infect Dis doi: 10.1086/605534 contributor: fullname: Lane MA, Barsanti MC, Santos CA, Ye – ident: 7 doi: 10.2169/internalmedicine.43.388 – volume: 81 start-page: 3 issn: 0035-9203 year: 1987 ident: 13 publication-title: Trans R Soc Trop Med Hyg doi: 10.1016/0035-9203(87)90267-7 contributor: fullname: Imai J – volume: 7 start-page: 699 issn: 0891-5520 year: 1993 ident: 1 publication-title: Infect Dis Clin North Am doi: 10.1016/S0891-5520(20)30550-X contributor: fullname: Harinasuta T, Pungpak S, Keystone J – volume: 70 start-page: 211 issn: 0001-706X year: 1998 ident: 24 publication-title: Acta Trop doi: 10.1016/S0001-706X(98)00024-2 contributor: fullname: Cui J, Wang ZQ, Wu F, Jin XX – volume: 28 start-page: 32 issn: 0125-1562 year: 1997 ident: 23 publication-title: Southeast Asian J Trop Med Public Health contributor: fullname: Cho SY, Kong Y, Kang SY – volume: 94 start-page: 661 issn: 0035-9203 year: 2000 ident: 2 publication-title: Trans R Soc Trop Med Hyg doi: 10.1016/S0035-9203(00)90223-2 contributor: fullname: Velez ID, Ortega J, Hurtado MI, et – volume: 40 start-page: 65 issn: 0177-2392 year: 1989 ident: 10 publication-title: Trop Med Parasitol contributor: fullname: Udonsi JK – volume: 11 start-page: 56 issn: 1229-0025 year: 2008 ident: 15 publication-title: Korean J Clin Microbiol doi: 10.5145/KJCM.2008.11.1.56 contributor: fullname: Kim HR, Lee MK, Hong ST, Chai JY – volume: 24 start-page: 138 issn: 0041-3232 year: 1972 ident: 25 publication-title: Trop Geogr Med contributor: fullname: Nwokolo C – ident: 19 doi: 10.1086/320516 – volume: 103 start-page: 1019 issn: 0035-9203 year: 2009 ident: 3 publication-title: Trans R Soc Trop Med Hyg doi: 10.1016/j.trstmh.2008.12.005 contributor: fullname: Vidamaly S, Choumlivong K, Keolouan – ident: 16 doi: 10.1378/chest.120.2.514 – volume: 42 start-page: 113 issn: 0065-308X year: 1999 ident: 11 publication-title: Adv Parasitol doi: 10.1016/S0065-308X(08)60149-9 contributor: fullname: Blair D, Xu ZB, Agatsuma T – volume: 28 start-page: 79 issn: 0023-4001 year: 1990 ident: 20 publication-title: Kisaengchunghak Chapchi doi: 10.3347/kjp.1990.28.Suppl.79 contributor: fullname: Choi DW – ident: 5 doi: 10.1378/chest.82.2.168 – volume: 90 start-page: 497 issn: 0074-0276 year: 1995 ident: 21 publication-title: Mem Inst Oswaldo Cruz doi: 10.1590/S0074-02761995000400012 contributor: fullname: Guevara A, Vieira JC, Araujo E, Cal – ident: 26 doi: 10.1378/chest.128.3.1423 – volume: 24 start-page: 25 issn: 0023-4001 year: 1986 ident: 14 publication-title: Kisaengchunghak Chapchi doi: 10.3347/kjp.1986.24.1.25 contributor: fullname: Cho SY, Kim SI, Kang SY, et al – volume: 36 start-page: 494 issn: 0096-0217 year: 1959 ident: 8 publication-title: Dis Chest doi: 10.1378/chest.36.5.494 contributor: fullname: Yang SP, Huang CT, Cheng CS, Chiang – volume: 124 start-page: 186 issn: 0003-0805 year: 1981 ident: 27 publication-title: Am Rev Respir Dis contributor: fullname: Minh VD, Engle P, Greenwood JR, Pre |
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Snippet | Purpose Most patients with pleuropulmonary paragonimiasis can be cured by the initial single set of Praziquantel (PZQ) treatment. However, several cases have... Most patients with pleuropulmonary paragonimiasis can be cured by the initial single set of Praziquantel (PZQ) treatment. However, several cases have been... PURPOSEMost patients with pleuropulmonary paragonimiasis can be cured by the initial single set of Praziquantel (PZQ) treatment. However, several cases have... |
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SubjectTerms | Adult chemotherapy effusion Female Humans Lung Diseases, Parasitic - drug therapy Lung Diseases, Parasitic - parasitology Male Middle Aged multi-set outcome paragonimiasis Paragonimiasis - drug therapy Paragonimiasis - parasitology Pleural Effusion - drug therapy Pleural Effusion - parasitology pleuropulmonary Praziquantel - therapeutic use Retrospective Studies Treatment Outcome |
Title | Can Pleuropulmonary Paragonimiasis be Cured by Only the 1st Set of Chemotherapy? Treatment Outcome and Clinical Features of Recently Developed Pleuropulmonary Paragonimiasis |
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ispartofPNX | Internal Medicine, 2011, Vol.50(13), pp.1365-1370 |
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