Charcot-Leyden Crystals Research Articles

Paragonimus and Paragonimiasis

This chapter discusses the advancement of research into Paragonimus and paragonimiasis in the taxonomic, immunodiagnostic, and chemotherapeutic fields. New species of Paragonimus have been reported with regard to classification of the lung flukes. At present, the life cycles of four species— P. westermani, P. kellicotti, P. ohirai and P. iloktsuenensis —are fully known. The wide variation in the histopathological findings in the lungs of man with paragonimiasis is because of differences in the number of infecting worms, the duration varying from the onset of this disease to autopsy and the susceptibility of the individuals to the worms. At an early stage of paragonimiasis, almost all cases show pleurisy of varying severity and occasionally pneumothorax. The most remarkable symptom is cough and blood-stained sputum. Paragonimiasis in endemic areas can be diagnosed clinically by an occasional light cough and yellowish brown pus-like sputum in which bloody spots or lines can sometimes be seen. The diagnosis is confirmed by microscopic examinations of the sputum or stool in order to find the eggs of Paragonimus . Charcot-Leyden's crystals in sputum assist the diagnosis. The methods of breaking the life cycle of the lung fluke of man are (1) destruction of the adults in the human host by treatment; (2) killing of reservoir hosts to destroy the adults; (3) disinfection of sputum and faeces of infected individuals to kill the eggs; (4) destruction of snail intermediate hosts to kill the larval stages; (5) killing of second intermediate hosts to destroy the metacercariae; (6) prevention of human infection by the metacercariae freed from the second intermediate hosts; and (7) prevention of human infection through eating the second intermediate host raw or partially cooked.

Pulmonary Paragonimiasis as a Cause of Loeffler's Syndrome

Loeffler (1), in 1932, described a new syndrome characterized by fleeting pulmonary infiltrations and eosinophilia of the peripheral blood in association with mild clinical symptoms. The syndrome represents a hypersensitivity reaction of the lungs to various antigens, the most common of which are pollens, drugs, horse serum, and certain helminths (2–10). Some of the pollens which have been implicated as etiologic factors are privet and lily-of-the-valley. The drugs which have been reported as causative agents include penicillin, para-aminosalicylic acid, sulfadiazine, and sulfonamide. There have been reports of cases in patients with trichinosis, influenza, ascariasis, clonorchiasis, strongyloidosis, and brucellosis. A review of the literature failed to reveal any example of Loeffler's syndrome in patients with pulmonary paragonimiasis. The purpose of this report is to describe 3 cases in which pulmonary paragonimiasis is believed to have been the underlying cause of the syndrome. Report of Cases Case I: C. Y. S., a male student, aged 20 years, entered the hospital Feb. 11, 1959, because of dry cough, abdominal distress, and mild diarrhea of one month duration. Physical examination was negative except for slightly diminished breath sounds and a few râles at the left base. The temperature was 38° C., pulse 90, respirations 24. The white cell count was 10,500 to 12,300, with 16 to 39 per cent eosinophils. The sputum showed operculated ova of Paragonimus westermanii; there were no other pathogens. Serum protein was 7.3 gm. per 100 ml.: albumin 38 per cent; alpha globulin 6, alpha-2, 19, beta 14.9, and gamma 24 per cent; A/G ratio 0.61. There were Charcot-Leyden crystals in the sputum. Roentgen examination, Feb. 11, 1959 (Fig. 1), showed a small area of mottled density at the base of the left lung with obscuration of the cardiac apex and costophrenic sulcus. The right diaphragm was elevated and the right costophrenic sulcus obliterated, indicative of an infrapulmonary effusion. On Feb.18 (Fig. 2), the left basal lesion had disappeared; the right diaphragm was still elevated. One month later, there was patchy density in the left upper and mid-lung field and the right hilus shadow was enlarged. On March 31, ill-defined, fluffy densities had appeared in the left mid-lung field and there was fluid at the right base. On April 24 (Fig. 3), extensive mottling was seen at the left base and about the left hilus with fluid rising to the level of the third rib anteriorly on the right. On July 23, multiple ring-like shadows were present in the left lung field, considered typical of pulmonary paragonimiasis. By Aug. 17, 1959 (Fig. 4), the areas of density had decreased bilaterally, with pleural thickening at the right base. The patient was treated with corticosteroids and chloroquine diphosphate and appeared well when discharged from the hospital Aug. 19, 1959.

Isolation of Charcot-Leyden crystals

A method is described for isolation of Charcot-Leyden crystals from high eosinophil-count blood specimens or from eosinophil rich exudates. Once the crystals have been formed, isolation is accomplished by lysing the blood cells with an enzyme and a wetting agent.

Sparganosis in Korea.

Summary Three cases of sparganosis in Koreans were encountered. The larvae varied from 23 to 30 cm. in length and were removed by surgery from the musculature of the abdominal or lower chest area. The histopathology of the tissues in contact with the worms is described, and the presence of Charcot-Leyden crystals noted in one case in the masses of degenerating eosinophil leucocytes which preponderated in the inflammatory response. The pathogenesis of the tissue lesion appears to be due to a direct toxic effect of substances which probably diffuse through the cuticle of the sparganum, as well as a possible sensitization to some of these products. All patients gave a history of eating raw snake. A specimen of Dinodon rufozonatum caught in the area was found to be heavily parasitized with plerocercoids. When guinea pigs were infected with these by inserting the larvae subcutaneously, the worms migrated and grew at a rapid rate. It is probable that human sparganosis is acquired in Korea by the consumption of raw snake, which is a fairly common practice in this area.

Histochemical studies of Charcot-Leyden crystals.

The Anatomical RecordVolume 116, Issue 1 p. 53-73 Article Histochemical studies of charcotleyden crystals† Clyde J. Dawe, Clyde J. Dawe Section of Surgical Pathology, Mayo Clinic, Rochester, Minnesota, and Department of Anatomy, University of Minnesota, MinneapolisSearch for more papers by this authorW. Lane Williams, W. Lane Williams Section of Surgical Pathology, Mayo Clinic, Rochester, Minnesota, and Department of Anatomy, University of Minnesota, Minneapolis The authors wish to thank Dr. Gerald T. Evans and Dr. Dorothy Sundberg for their aid and co-operation during the preliminary studies.Search for more papers by this author Clyde J. Dawe, Clyde J. Dawe Section of Surgical Pathology, Mayo Clinic, Rochester, Minnesota, and Department of Anatomy, University of Minnesota, MinneapolisSearch for more papers by this authorW. Lane Williams, W. Lane Williams Section of Surgical Pathology, Mayo Clinic, Rochester, Minnesota, and Department of Anatomy, University of Minnesota, Minneapolis The authors wish to thank Dr. Gerald T. Evans and Dr. Dorothy Sundberg for their aid and co-operation during the preliminary studies.Search for more papers by this author First published: May 1953 https://doi.org/10.1002/ar.1091160106Citations: 6 † This study was supported by grants from the National Heart Institute (H 728C), U.S.P.H.S., and from the Medical Research Fund of the Graduate School of the University of Minnesota. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume116, Issue1May 1953Pages 53-73 RelatedInformation

Expectoration of abnormal substances and particles including parasites: Their diagnostic significance

In many intrathoracic diseases an abnormal substance or body will occasionally be expectorated either directly or in the sputum. The detection of this substance is not only of diagnostic significance but is often pathognomonic of that disease. A list of such substances which have been considered in this article includes: caseous particles, broncholiths, carbon particles, asbestos bodies, foreign bodies, food, hair, bone, chyle, oil, fat, bronchial casts, Curschmann's spirals, Charcot-Leyden crystals and malignant tumor masses. Also, the following parasites are considered: ameba, echinococcus, ascaris, strongyloides, Paragonimus westermanni, Syngamus trachealis and mites.

STUDIES ON CHARCOT-LEYDEN CRYSTALS

Abstract 1. Synthetic detergents of the anionic, cationic and nonionic types result in the rapid and constant formation of Charcot-Leyden crystals from eosinophils. 2. Charcot-Leyden crystals have a negative crystalline birefringence and form penetration twins. 3. The changes taking place in the eosinophil in the formation of Charcot-Leyden crystals under the influence of wetting agents, utilizing phase and polarizing microscopy, are described. 4. In the formation of Charcot-Leyden crystals with wetting agents, the nucleus of the eosinophil lyses with no appreciable effect on the granules. 5. In the formation of Charcot-Leyden crystals with a wetting agent, there is no change in the lipoid cortex of the eosinophil as demonstrated by staining with sudan black B. 6. Charcot-Leyden crystals undergo changes on standing that affect their solubilities. 7. The staining reactions and solubilities of Charcot-Leyden crystals are described. 8. Oxyhemoglobin crystals constantly form from red cells on exposure to Aerosol MA; on two occasions, tyrosine crystals formed from the blood of a patient with chronic myelogenous leukemia. 9. Evidence is offered that Charcot-Leyden crystals are crystalline proteins derived only from the nucleus of the eosinophil.

Charcot-Leyden crystals: A study of the conditions necessary for their formation

1. 1. Charcot-Leyden crystals found in the blood of patients with high absolute eosinophilia, originate in individual eosinophiles. Only a minority of the eosinophiles present develops Charcot-Leyden crystals. 2. 2. Supravital staining of eosinophilic granules does not interfere with the development of Charcot-Leyden crystals which are of the same shape and color as in unstained preparations. Dilution prevents the formation of Charcot-Leyden crystals. 3. 3. Concentrations of eosinophiles of various sources: blister fluid, nasal secretion, failed to produce Charcot-Leyden crystals. After separation of the cellular from the liquid fraction of blister fluid, a considerable number of Charcot-Leyden crystals were seen to develop in cellular material. 4. 4. Addition of intact red blood cells obtained from C-L positive patients with high absolute eosinophilia increased both number and size of Charcot-Leyden crystals in C-L positive, centrifuged cellular material; it stimulated the formation of Charcot-Leyden crystals in several though few instances of previously C-L negative concentrations. Addition of intact red blood cells from C-L negative patients or of the stroma of red blood cells from either source did not substantially interfere with the development in Charcot-Leyden crystals in C-L positive material, but no stimulation of development of Charcot-Leyden crystals in previously C-L negative preparations was seen. 5. 5. Addition of substances other than red blood cells, including serum, plasma, and solutions of breakdown products of red blood cells prevented the formation of Charcot-Leyden crystals in C-L positive material and had no influence on C-L negative preparations. 6. 6. Significance and limitations of these findings are discussed.

Observations on the pathogenicity of Isospora hominis, Rivolta, emend. Dobell, based on a second case of human coccidiosis in Nigeria; with remarks on the significance of Charcot-Leyden crystals in the f˦ces

Observations on the pathogenicity of Isospora hominis, Rivolta, emend. Dobell, based on a second case of human coccidiosis in Nigeria; with remarks on the significance of Charcot-Leyden crystals in the f˦ces

The Value of Laboratory Reports on Stools in Cases of Suspected Amœbic Dysentery, and Their Interpretation by the Clinician; with a Special Note on the Diagnostic Significance of Charcot-Leyden Crystals

The Value of Laboratory Reports on Stools in Cases of Suspected Amœbic Dysentery, and Their Interpretation by the Clinician; with a Special Note on the Diagnostic Significance of Charcot-Leyden Crystals

INTESTINAL EOSINOPHILIA, WITH REPORT OF A CASE

The occurrence of eosinophilic cells or Charcot-Leyden crystals in the mucus of stools has been occasionally reported almost ever since Ehrlich first described the eosinophil in 1879. They have been found with greatest frequency in cases of parasitic disease, especially amebiasis and hookworm disease, and in the latter condition the finding has been reported to be almost a constant one. It has also been known for a long time that they may occur in certain non-parasitic conditions, notably mucous colitis. But the great variability of the intestinal eosinophilia in cases otherwise entirely similar has made the finding rather a clinical enigma than a sign of any diagnostic importance. For this reason Schmidt 2 has considered it inadvisable to attempt any grouping of cases on this basis. In his opinion eosinophils may occur in varying numbers in intestinal mucus in almost any type of colitis. In a few cases, however,

THE NATURE AND TREATMENT OF BRONCHIAL ASTHMA

Until about five years ago, the nature of this distressing affection was a matter for considerable discussion. The very terms applied to it attest the uncertainty regarding its pathogenesis. Thus it was called bronchial, spasmodic, and asthma. The appellations nervous and idiopathic have reference to its obscure causation, while the terms bronchial and spasmodic denote rather an attempt to define its pathology, if, indeed, it possesses any definite pathology. By some writers the dyspnea was believed due to spasm, but even among these advocates, complete agreement did not exist. Hyde-Salter, Biermer and others argued in favor of spasm of the bronchioles, while Wintrich and Bamberger stoutly maintained inspiratory spasm of the diaphragm to be the condition responsible for the respiratory distress. On the other hand, Weber contended for a fluxionary hyperemia as the essential nature of the asthma. Then we find the Curschmann spirals or the Charcot-Leyden crystals