Clinical Manifestation of Clonorchiasis in Korea

다국어 초록 (Multilingual Abstract)

Clonorchis sinensis infected cases who admitted to the Yonsei University Severance Hospital for the July 1964 through August 1968 were searched to visualize the clinical pictures of clonorchiasis and laboratory findings by checking the charts. The number of the available cases for the present study was 424, Actualy, they admitted with another disease, but all the cases were confirmed egg-positive of Clonorchis sinensis.
1. The highest incidence of infected cases was found in 41-50 yrs. group of male and in 31-40yrs. group of female. Sex ratio of male per female was 4.17 : 1.
2. As a complication, liver diseases (20.6%); liver cirrhosis (10.3%), hepatoma (3.3%), cholelithiasis (0.9%) and cholecystitis (2.1%), were found. Gastrointestinal disturbance (30.8%), such as gastritis (9.6%) and peptic ulcer (10.1%) and other diseases, such as pulmonary tuberculosis (17.6%), hypertension (7.8%), Neurosis (6.6%), were observed.
3. Among the frequent subjective symptoms, gastrointestinal symptoms; such as indigestion (32.9%), anorexia (19.3%), epigastric pain (25.1%) and right upper quardrant discomfort (11.3%) and respiratory symptoms; such as short breathness (15.7%) and chest discomfort or pain (10.1%) and other general symptoms; such as fatigability (32.9%), headache (25.6%) and dizziness (12.5%), were found.
4. Objective signs observed in clonorchiasis patients were; edema (8.5%), jaundice (9.0%), hepatomegaly (27.5%), splenomegaly (5.2%), tenderness on the epigastrium and right upper quardrant of abdomen (14.1%). abdominal distension (8.2%), ascites (4.5%), spider hemangioma (3.8%) and telangiectasis (1.6%).
5. Single infection with Clonorchis sinensis was only 6.6%. Most of the cases were simultaneously infected with Ascaris lumbricoides (30.1%), hookworm (24.0%), trichostrongylus orientalis (43.2%), Trichocephalus trichiurus (85.5%), Entamoeba histolytica (5.2%) and Entamoeba coli (58.6%).
6. Hemoglobin value below 12mg/l was in 43.5% and the eosinphilia were in 29.6%.
7. Tasting sugar of the blood decresed in 18.2% of observed cases. Decreased albumin and increased globulin was found in 20.6% and 42.6% respectively, and A/G ratio was reversed in 11.7%. BUN and NPN decreased in 27.0% and in 2.4%, respectively. Total bilirubin increased in 32.3% of the observed cases.
8. B.S.P. retention test was positive in 58.6% and thymol turbidity test was positive in 45.3%. Total cholesterol values increased only in 8.0%, but cholesterol ester decreased in 66.2% out of observed cases. Low prothrombin was found in 62.1%. Alkaline phosphatase, SGOT and SGPT increased in 48.5%, 34.1% and 32.1%, respectively.
9. Urine protein, urine sugar and urine bile were positive in 17.0%, 3.4% and 14.8%, respectively. And urine urobilinogen increased in 12.1% out of clonorchiasis cases.
From the above results, it is summarized that the Clonorchis sinensis infection may cause gastro-intestinal disorders, depress the liver functions and may rise cholangioma or a predisposing factor of liver cirrhosis.