Parasitic Hypoproteinemia :A Diagnostic Dilemma in an Immuno competent Patient

  • Somnath Maitra Associate Professor, Department of General Medicine, JIMSH, Budge, Kolkata, West Bengal, India https://orcid.org/0000-0001-7906-3570
  • Debes Pal Associate Professor, Department of Pathology, JIMSH, Budge, Kolkata, West Bengal, India
  • Koushik Ray Assistant Professor, Department of Anatomy, JIMSH, Budge, Kolkata, West Bengal, India
  • Sk Adnan Yusuf Senior Resident, Department of General Medicine, JIMSH, Budge, Kolkata, West Bengal, India
Keywords: Strongyloidiasis,hypoalbuminemia,malabsorption,anemia

Abstract

Strongyloidiasis is caused by a nematode helminth which causes multisystem involvement with signsand symptoms related to the gastrointestinal, pulmonary, dermatological and nervous systems. Theindex case discussed here presented with edema, hypoalbuminemia, malnutrition and anemia withurease positive duodenal ulcer. Duodenal biopsy suggested malabsorption, and strongyloidiasis wasdetected in the biopsy, which clinched the diagnosis and treatment was given with ivermectin, afterwhich the patient improved and responded to treatment. The importance lies in the fact thatparasitic infections may cause malabsorption even in immunocompetent patients, which is a rareentity but must not be missed as it responds to treatment promptly, which is cheap and effective

Downloads

Download data is not yet available.

References

Patel J, Gupta D, Rathi C, Parikh P, Ingle M, Sawant P. Uncommon presentation of Strongyloidiasis: chronic malabsorption, multiple small bowel strictures and appendicitis in HTLV-1 positive patient. Trop Gastroenterol. 2015 Jul-Sep;36(3):212-5. doi: 10.7869/tg.293.

Arsić-Arsenijević, Valentina, et al. Fatal Strongyloides stercoralis infection in a young woman with lupus glomerulonephritis. Journal of nephrology 18.6 (2005): 787-790.

Weller PF, Leder KL. Strongyloidiasis. Available at http://www.uptodate.com/contents/strongyloidiasis?source=search_result&selectedTitle=1%7E4. Accessed: January 29, 2008.

Asdamongkol N, Pornsuriyasak P, Sungkanuparph S. Risk factors for strongyloidiasis hyperinfection and clinical outcomes. Southeast Asian J Trop Med Public Health. 2006 Sep;37(5):875-84.

Fardet L, Généreau T, Poirot JL, Guidet B, Kettaneh A, Cabane J. Severe strongyloidiasis in corticosteroid-treated patients: case series and literature review. J Infect. 2007 Jan;54(1):18-27. doi: 10.1016/j.jinf.2006.01.016.

Guyomard JL, Chevrier S, Bertholom JL, Guigen C, Charlin JF. Découverte d'une infestation à Anguillule, 25 ans après retour de zone d'endémie, à l'occasion d'une corticothérapie pour traumatisme oculaire [Finding of Strongyloides stercoralis infection, 25 years after leaving the endemic area, upon corticotherapy for ocular trauma]. J Fr Ophtalmol. 2007 Feb;30(2):e4. French. doi: 10.1016/s0181-5512(07)89571-4.

Porto AF, Neva FA, Bittencourt H, Lisboa W, Thompson R, Alcântara L, Carvalho EM. HTLV-1 decreases Th2 type of immune response in patients with strongyloidiasis. Parasite Immunol. 2001 Sep;23(9):503-7. doi: 10.1046/j.1365-3024.2001.00407.x.

Satoh, M., et al. Reduced efficacy of treatment of strongyloidiasis in HTLV-I carriers related to enhanced expression of IFN-γ and TGF-β1." Clinical & Experimental Immunology 127.2 (2002): 354-359.

Porto, Maria Aurelia F., et al. Atypical clinical presentation of strongyloidiasis in a patient co-infected with human T cell lymphotrophic virus type I. The American journal of tropical medicine and hygiene 72.2 (2005): 124-125.

Carvalho, E. M., and A. Da Fonseca Porto. Epidemiological and clinical interaction between HTLV‐1 and Strongyloides stercoralis." Parasite immunology 26.11‐12 (2004): 487-497.

Thompson BF, Fry LC, Wells CD, Olmos M, Lee DH, Lazenby AJ, Mönkemüller KE. The spectrum of GI strongyloidiasis: an endoscopic-pathologic study. Gastrointest Endosc. 2004 Jun;59(7):906-10. doi: 10.1016/s0016-5107(04)00337-2.

Tiwari S, Rautaraya B, Tripathy KP. Hyperinfection of Strongyloides stercoralis in an immunocompetent patient. Trop Parasitol. 2012 Jul;2(2):135-7. doi: 10.4103/2229-5070.105182.

Tachamo N, Nazir S, Lohani S, Karmacharya P. Strongyloidiasis in the immunocompetent: an overlooked infection. J Community Hosp Intern Med Perspect. 2016 Sep 7;6(4):32038. doi: 10.3402/jchimp.v6.32038.

How to Cite
1.
Somnath Maitra, DP, Koushik Ray, SAY. Parasitic Hypoproteinemia :A Diagnostic Dilemma in an Immuno competent Patient. Int J Med Res Rev [Internet]. 2022Apr.29 [cited 2022May25];10(2):81-4. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/1379
Section
Case Report