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Disseminated strongyloidiasis in a patient with membranoproliferative glomerulonephritis-case report.

Malakoutian T, Mohammadi R, Asgari M, Amouzegar A - Iran J Parasitol (2015 Jan-Mar)

Bottom Line: In immunocompromised patients, infection can cause Strongyloides hyperinfection syndrome (S.H.S) that is associated with serious morbidity and mortality.As various infections are one of the leading causes of membranoproliferative glomerulonephritis (MPGN), we should consider subclinical strongyloidiasis as a possible underlying disease, especially in endemic areas.Here we describe a case of strongyloidiasis following immunosuppressive therapy for MPGN, the diagnosis of which was made, only a few hours before death, by stomach biopsy.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Department of Internal Medicine, Hospital Management and Research Center(HMRC), Iran university of Medical science, Tehran, Iran.

ABSTRACT
Strongyloides stercoralis (SS) is a unique nematode with an auto infective cycle, so that it completes its life cycle within the human host and can live there for many years. In immunocompromised patients, infection can cause Strongyloides hyperinfection syndrome (S.H.S) that is associated with serious morbidity and mortality. As various infections are one of the leading causes of membranoproliferative glomerulonephritis (MPGN), we should consider subclinical strongyloidiasis as a possible underlying disease, especially in endemic areas. Here we describe a case of strongyloidiasis following immunosuppressive therapy for MPGN, the diagnosis of which was made, only a few hours before death, by stomach biopsy.

No MeSH data available.


Related in: MedlinePlus

Gastric mucosa of the patient showing inflammatory infiltration of lamina propria and eggs (A) and rhabditiform larvae (B) of Strongyloides stercoralis in the glands under light microscopy in a biopsy made by endoscopic procedure (H&E staining). Original picture
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Figure 2: Gastric mucosa of the patient showing inflammatory infiltration of lamina propria and eggs (A) and rhabditiform larvae (B) of Strongyloides stercoralis in the glands under light microscopy in a biopsy made by endoscopic procedure (H&E staining). Original picture

Mentions: Cyclophosphamie was discontinued, broad-spectrum antibiotic therapy was started and hemodialysis was performed. One day after admission, upper gastrointestinal (GI) endoscopy was performed, because of intractable vomiting which showed severe erythematous lesions in stomach mucosa. On third hospital day, his general condition deteriorated rapidly and the patient developed dyspnea. A chest CT scan demonstrated diffuse alveolar infiltrates. He was intubated due to worsening of dyspnea and massive hemoptysis. Histological examination of gastric biopsy specimens revealed numerous cross-sections of eggs and rhabditiform larvae of SS (Fig. 2).


Disseminated strongyloidiasis in a patient with membranoproliferative glomerulonephritis-case report.

Malakoutian T, Mohammadi R, Asgari M, Amouzegar A - Iran J Parasitol (2015 Jan-Mar)

Gastric mucosa of the patient showing inflammatory infiltration of lamina propria and eggs (A) and rhabditiform larvae (B) of Strongyloides stercoralis in the glands under light microscopy in a biopsy made by endoscopic procedure (H&E staining). Original picture
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4403535&req=5

Figure 2: Gastric mucosa of the patient showing inflammatory infiltration of lamina propria and eggs (A) and rhabditiform larvae (B) of Strongyloides stercoralis in the glands under light microscopy in a biopsy made by endoscopic procedure (H&E staining). Original picture
Mentions: Cyclophosphamie was discontinued, broad-spectrum antibiotic therapy was started and hemodialysis was performed. One day after admission, upper gastrointestinal (GI) endoscopy was performed, because of intractable vomiting which showed severe erythematous lesions in stomach mucosa. On third hospital day, his general condition deteriorated rapidly and the patient developed dyspnea. A chest CT scan demonstrated diffuse alveolar infiltrates. He was intubated due to worsening of dyspnea and massive hemoptysis. Histological examination of gastric biopsy specimens revealed numerous cross-sections of eggs and rhabditiform larvae of SS (Fig. 2).

Bottom Line: In immunocompromised patients, infection can cause Strongyloides hyperinfection syndrome (S.H.S) that is associated with serious morbidity and mortality.As various infections are one of the leading causes of membranoproliferative glomerulonephritis (MPGN), we should consider subclinical strongyloidiasis as a possible underlying disease, especially in endemic areas.Here we describe a case of strongyloidiasis following immunosuppressive therapy for MPGN, the diagnosis of which was made, only a few hours before death, by stomach biopsy.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Department of Internal Medicine, Hospital Management and Research Center(HMRC), Iran university of Medical science, Tehran, Iran.

ABSTRACT
Strongyloides stercoralis (SS) is a unique nematode with an auto infective cycle, so that it completes its life cycle within the human host and can live there for many years. In immunocompromised patients, infection can cause Strongyloides hyperinfection syndrome (S.H.S) that is associated with serious morbidity and mortality. As various infections are one of the leading causes of membranoproliferative glomerulonephritis (MPGN), we should consider subclinical strongyloidiasis as a possible underlying disease, especially in endemic areas. Here we describe a case of strongyloidiasis following immunosuppressive therapy for MPGN, the diagnosis of which was made, only a few hours before death, by stomach biopsy.

No MeSH data available.


Related in: MedlinePlus