IBD or strongyloidiasis?
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 m...
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| Format: | Article |
| Language: | English |
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Aran Ediciones
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| Series: | Revista Espanola de Enfermedades Digestivas |
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| Online Access: | http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082016000800018&lng=en&tlng=en |
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| author | Marta Maia Boscá-Watts Andrea Marco-Marqués Ester Savall-Núñez Ana Artero-Fullana Bernardo Lanza-Reynolds Verónica Andrade-Gamarra Víctor Puglia-Santos Octavio Burgués-Gasión Francisco Mora-Miguel |
| author_facet | Marta Maia Boscá-Watts Andrea Marco-Marqués Ester Savall-Núñez Ana Artero-Fullana Bernardo Lanza-Reynolds Verónica Andrade-Gamarra Víctor Puglia-Santos Octavio Burgués-Gasión Francisco Mora-Miguel |
| author_sort | Marta Maia Boscá-Watts |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-11T23:08:09Z |
| format | Article |
| id | doaj.art-b133b6b81cc2477f989fc1d5959875a9 |
| institution | Directory Open Access Journal |
| issn | 1130-0108 |
| language | English |
| last_indexed | 2024-12-11T23:08:09Z |
| publisher | Aran Ediciones |
| record_format | Article |
| series | Revista Espanola de Enfermedades Digestivas |
| spelling | doaj.art-b133b6b81cc2477f989fc1d5959875a92022-12-22T00:46:49ZengAran EdicionesRevista Espanola de Enfermedades Digestivas1130-0108108851652010.17235/reed.2015.3847/2015S1130-01082016000800018IBD or strongyloidiasis?Marta Maia Boscá-Watts0Andrea Marco-Marqués1Ester Savall-Núñez2Ana Artero-Fullana3Bernardo Lanza-Reynolds4Verónica Andrade-Gamarra5Víctor Puglia-Santos6Octavio Burgués-Gasión7Francisco Mora-Miguel8Hospital Clínico Universitario de ValenciaHospital Clínico Universitario de ValenciaHospital Clínico Universitario de ValenciaHospital Clínico Universitario de ValenciaHospital Clínico Universitario de ValenciaHospital Clínico Universitario de ValenciaHospital Clínico Universitario de ValenciaHospital Clínico Universitario de ValenciaHospital Clínico Universitario de ValenciaIntroduction: 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.http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082016000800018&lng=en&tlng=enIBDStrongyloides stercolarisSIADHImmunosuppression |
| spellingShingle | Marta Maia Boscá-Watts Andrea Marco-Marqués Ester Savall-Núñez Ana Artero-Fullana Bernardo Lanza-Reynolds Verónica Andrade-Gamarra Víctor Puglia-Santos Octavio Burgués-Gasión Francisco Mora-Miguel IBD or strongyloidiasis? Revista Espanola de Enfermedades Digestivas IBD Strongyloides stercolaris SIADH Immunosuppression |
| title | IBD or strongyloidiasis? |
| title_full | IBD or strongyloidiasis? |
| title_fullStr | IBD or strongyloidiasis? |
| title_full_unstemmed | IBD or strongyloidiasis? |
| title_short | IBD or strongyloidiasis? |
| title_sort | ibd or strongyloidiasis |
| topic | IBD Strongyloides stercolaris SIADH Immunosuppression |
| url | http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082016000800018&lng=en&tlng=en |
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