Dignositic value of platelets detection for children with Paragonimiasis

Abstract

Objective To evaluate the clinical value of platelets detection in the diagnosis of children with paragonimiasis. Methods The clinical data of 19 children with paragonimiasis who were treated at Department of Infectious Diseases and Department of Pediatrics of Shiyan City Renmin Hospital from January 2010 to December 2017 were reviewed, retrospectively. The detected parameters included blood platelet count (PLT), white blood count (WBC), eosinophil count (EOS), multi-slice computed tomography (MSCT) and serous cavity color Doppler ultrasonography. The relationship between PLT changes and clinical manifestations and imaging changes of paragonimiasis were analyzed. According to whether the level of PLT was higher than the normal value, the patients were divided into two groups: increased PLT group (12 cases) and normal PLT group (7 cases). Results There were 12 case times with abnormal respiratory symptoms and signs in increased PLT group, MSCT showed all patients with lung lesions in this group (among whom, 9 patients with bilateral pleural effusion and 3 patients with unilateral pleural effusion). There were 1 case with abnormal respiratory symptoms and signs in normal PLT group, MSCT showed pleural effusions in 1 patient. After treatment, the patients in increased PLT group returned to normal with the regression of pulmonary lesions; but there was no change in normal PLT group before and after treatment. The changes of WBC level: 16 patients with normal level of WBC and 3 patients with increased level of WBC. One patient with increased WBC level was complicated with tonsil bacterial infection, intestinal infection and intrapulmonary infection, but the level of WBC returned to normal after antibiotic treatment. No abnormal WBC was found in 19 cases during praziquantel treatment. The changes of EOS level: EOS increased significantly to 15.9%-54.8%. The EOS ratio decreased to less than 2 times of the normal high limit at the end of the deworming course, and decreased to normal level one month after the end of the EOS course. Chest MSCT: 13 case times with lung focus (12 case times with PLT increase, 1 case with PLT normal), 13 case times with pleural effusion (9 case times with bilateral pleural effusion and 3 case times with unilateral pleural effusion in PLT increase group; one case time with unilateral pleural effusion in PLT normal group) were found. There were 2 cases with pericardial effusion (one case in each group), 4 case times with mediastinal and axillary lymph node enlargement (2 case times in each group). With the marked effect of deworming treatment, MSCT showed that the chest lesions disappeared. Thoracopulmonary paragliasis was the main type of paragliasis. Color Doppler ultrasound showed that 13 case times with pleural effusion (including 9 case times on both sides and 4 case times on one side), 2 cases with pericardial hydrops and 2 cases with abdominal effusions. There were 13 cases of pleural effusions (bilateral 9 cases, 4 cases unilateral), 2 cases of pericardial effusion and 2 cases of abdominal effusion. Color Doppler ultrasound was performed in 13 cases of pleural effusion (including 9 cases on both sides and 4 cases on one side), 2 cases of pericardial hydrops and 2 cases of abdominal effusions. There were 13 cases of pleural effusions (bilateral 9 cases, 4 cases unilateral), 2 cases of pericardial effusion and 2 cases of abdominal effusion. Pleural and abdominal effusions were more common in chest, lung type and abdominal paragliasis, and serous effusion disappeared with the effect of deworming. Conclusions The increase of PLT level was of significance in the diagnosis of thoracic and pulmonary paragliasis. Combined with the changes of EOS, it was more beneficial to the diagnosis of pulmonary clonorchiasis. Key words: Paragonimiasis, children; Platelets; Paragonimiasis of lung; Clinical diagnosis