Serum C-reactive protein (CRP) values of patients infected with Taenia saginata.

Abstract

Elevated serum C-reactive protein (CRP) values are identified in patients with infections, some tumors or various types of tissue destruction, and clinical measurement of serum CRP is valuable as a screening test for organic diseases and as a sensitive index of disease activity and response to therapy in the disease mentioned above (Pepys, 1981). But, to our knowledge, CRP has been given but scant attention in cases of tapeworm infection. Human infection with Taenia saginata is uncommon in Japan and clinical manifestations of this tapeworm infection are mild or symptomless, but infection with T saginata is an important parasitic diseases because of its world wide distribution.From April 1987 to March 1991, we treated 5 patients with T. saginata infection. All of the patients were Japanese males aged 23 to 66 years old. None of them had a previous history of the tapeworm infection. All of the infections were asymptomatic, except for the discomfort and embarrassment occasioned by the crawling of proglottids from the anus. The place of contraction of 3 patients was Ethiopia, 1 patient Japan and 1 patient unknown. All of the patients expelled a single T. saginata with intraduodenal gastrographin injection or oral administration of paromomycin sulphate. Before the therapy, serum CRP levels were measured with a Behring Nephelometer Analyzer with CRP-Latex reagent kit.The serum CRP value of all patients was under 0.3 mg/dl and this value was in normal range. The results are shown in Table 1.The results reported here show that CRP values of patients infected with a single T. saginata are in the normal range. It has been reported that CRP was found in a human liver culture but not in bone marrow, spleen, thyroid, mammary gland or thoracic duct lymphocytes in culture (Hurlimann et al., 1966) and that interleukin-1 (IL-1) and interleukin-6 (IL-6) both stimulated liver synthesis of CRP and that probably IL-6 played a key role in stimulation of CRP (Hazenberg et al., 1988). The results of these reports indicate that the liver is an important organ for producing CRP and that the production is stimulated by interleukins stimulated by tissue damage. T. saginata, whose head has four suckers lives by attaching to the small intestinal wall. Our results suggest that single infections with T. saginata may not induce interleukins sufficient to increase the CRP value. It is thought that injury to the intestinal wall by a single T. saginata is so mild that intestinal infection by the tapeworm does not stimulate production of CRP in the liver to clinically detectable levels. We think that if an elevated serum CRP value is observed in an asymptomatic person infected with a T. saginata, other abnormal accompanying conditions such as neoplasma or collagen disease should be considered.