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Current perspectives on giardiasis.

C H Fisher, K S Oh, T M Bayless

    The American Journal of Roentgenology, Radium Therapy, and Nuclear Medicine
    |September 1, 1975
    PubMed
    Summary
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    Giardia lamblia infection causes diarrhea and malabsorption, with diagnosis via stool cysts or biopsy. Immune status influences small bowel changes, which may or may not reverse after parasite eradication.

    Area of Science:

    • Gastroenterology
    • Immunology
    • Infectious Diseases

    Background:

    • Giardia lamblia infestation is a common cause of diarrhea and malabsorption.
    • Diagnosis typically involves identifying cysts in stool, but may require intestinal biopsy.
    • Radiographic findings in the small bowel can vary depending on immune status.

    Purpose of the Study:

    • To describe the spectrum of gastrointestinal and immunological changes associated with Giardia lamblia infestation.
    • To correlate radiographic findings with immune status and treatment outcomes.
    • To investigate the relationship between giardiasis, immune deficiencies, and nodular lymphoid hyperplasia.

    Main Methods:

    • Review of clinical presentations, diagnostic methods (stool examination, biopsy, radiography), and immune profiles of patients with giardiasis.

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  • Analysis of radiographic changes in the small bowel.
  • Correlation of findings with patient immune status (IgA deficiency, hypogammaglobulinemia, dysgammaglobulinemia) and response to antiparasitic treatment.

    • Main Results:

    • In immunocompetent individuals, giardiasis may present with normal small bowel findings or an inflammatory bowel disease pattern, often reversible after treatment.
    • Patients with IgA deficiency may develop nodular lymphoid hyperplasia, which is typically irreversible.
    • Hypogammaglobulinemia or dysgammaglobulinemia in conjunction with giardiasis can lead to a sprue-like pattern, frequently persistent post-treatment.

    Conclusions:

    • Giardia lamblia infestation impacts the small bowel differently based on the host's immune status.
    • Nodular lymphoid hyperplasia associated with IgA deficiency and giardiasis is often a permanent change.
    • The sprue pattern seen in certain immunodeficient states with giardiasis tends to be long-lasting, highlighting the interplay between infection and immune dysregulation.