Strongyloidiasis in a Diabetic Patient Accompanied by Gastrointestinal Stromal Tumor: Cause of Eosinophilia Unresponsive to Steroid Therapy.
10.3347/kjp.2015.53.2.223
- Author:
Eun Jeong WON
1
;
Jin JEON
;
Young Il KOH
;
Dong Wook RYANG
Author Information
1. Department of Laboratory Medicine, Chonnam National University Hospital, Gwangju 501-757, Korea. dwryang@chonnam.ac.kr
- Publication Type:Case Reports ; Research Support, Non-U.S. Gov't
- Keywords:
Strongyloides stercoralis;
imatinib;
gastrointestinal stromal tumor (GIST);
PCR;
hypereosinophilic syndrome
- MeSH:
Aged;
Albendazole/administration & dosage;
Animals;
Diabetes Mellitus, Type 2/complications;
Eosinophilia/complications/*drug therapy;
Female;
Gastrointestinal Stromal Tumors/complications/*drug therapy;
Humans;
Imatinib Mesylate/*administration & dosage;
Steroids/*administration & dosage;
Strongyloides stercoralis/genetics/isolation & purification/physiology;
Strongyloidiasis/*drug therapy/parasitology
- From:The Korean Journal of Parasitology
2015;53(2):223-226
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report here a case of strongyloidiasis in a 72-year-old diabetic patient (woman) accompanied by gastrointestinal stromal tumor receiving imatinib therapy, first diagnosed as hypereosinophilic syndrome and treated with steroids for uncontrolled eosinophilia. She suffered from lower back pain and intermittent abdominal discomfort with nausea and diagnosed with gastrointestinal stromal tumor. After post-operative imatinib treatment eosinophilia persisted, so that steroid therapy was started under an impression of hypereosinophilic syndrome. In spite of 6 months steroid therapy, eosinophilia persisted. Stool examination was performed to rule out intestinal helminth infections. Rhabditoid larvae of Strongyloides stercoralis were detected and the patient was diagnosed as strongyloidiasis. This diagnosis was confirmed again by PCR. The patient was treated with albendazole for 14 days and her abdominal pain and diarrhea improved. This case highlights the need for thorough investigation, including molecular approaches, to test for strongyloidiasis before and during steroid therapies.
