IBD or strongyloidiasis?
| Autor: | Boscá Watts MM; Gastroenterología y Hepatología, Hospital Clínico Universitario de Valencia, España., Marco Marqués A; Medicina Digestiva, Hospital Clínico Universitario. Valencia, ESPAÑA., Savall-Núñez E; Endocrinología, Hospital Clínico Universitario. Valencia, ESPAÑA., Artero-Fullana A; Endocrinología, Hospital Clínico Universitario. Valencia, ESPAÑA., Lanza Reynolds B; Medicina Digestiva, Hospital Clínico Universitario. Valencia, ESPAÑA., Andrade Gamarra V; Anatomía Patológica, Hospital Clínico Universitario. Valencia, ESPAÑA., Puglia Santos V; Anatomía Patológica, Hospital Clínico Universitario. Valencia, ESPAÑA., Burgués Gasión O; Anatomía Patológica, Hospital Clínico Universitario. Valencia, ESPAÑA., Mora Miguel F; Medicina Digestiva, Hospital Clínico Universitario. Valencia, ESPAÑA. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva [Rev Esp Enferm Dig] 2016 Aug; Vol. 108 (8), pp. 516-20. |
| DOI: | 10.17235/reed.2015.3847/2015 |
| Abstrakt: | Introduction: Strongyloides has been shown to infrequently mimic inflammatory bowel disease (IBD) or to disseminate when a patient with IBD and unrecognized strongyloides is treated with immunosupression. Case Report: A man from Ecuador, living in Spain for years, with a history of type 2 diabetes mellitus and psoriasis treated with topical corticosteroids, was admitted to the hospital with an 8-month history of diarrhoea. Blood tests showed hyperglycemia, hyponatremia, elevated CRP and faecal calprotectin. Colonoscopy suggested IBD. The patient improved with steroids, pending biopsy results, and he was discharged. Biopies were compatible with IBD, but careful examination revealed strongyloides. He was given a prescription of albendazole. He had to be readmitted due to SIADH, which resolved with fluid restriction. Upon discharge albendazole was prescribed again. The patient skipped most of the out-patient-clinic visits. He returned a year later on 10 mg/week methotrexate, asymptomatic, with 20% eosinophilia, and admitting he had never taken the strongyloides treatment for economical reasons. He then received a week of oral albendazol at the hospital. Biopsies and blood cell count were afterwards normal (eosinophils 3.1%) and serology for strongyloides antibodies was negative. Discussion: This case is of interest for four rarely concurring reasons. It´s a worm infection that mimics IBD; the infection was diagnosed by colon biopsy; the infection caused a SIADH; and, most interestingly, even though the patient is on immunosupression, he remains asymptomatic. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|