Endoscopic and histopathological study on the duodenum of Strongyloides stercoralis hyperinfection |
| |
Authors: | Kishimoto Kazuto Hokama Akira Hirata Tetsuo Ihama Yasushix Nakamoto Manabu Kinjo Nagisa Kinjo Fukunori Fujita Jiro |
| |
Affiliation: | Kazuto Kishimoto, Yasushi Ihama, Manabu Nakamoto, Nagisa Kinjo, Fukunori Kinjo, Department of Endoscopy, Ryukyu University Hospital, Okinawa 903-0215, Japan;Akira Hokama, Tetsuo Hirata, Jiro Fujita, Department of Medicine and Therapeutics (First Department of Internal Medicine), Control and Prevention of Infectious Disease, Faculty of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan |
| |
Abstract: | AIM: To investigate endoscopic and histopathological findings in the duodenum of patients with Strongyloides stercoralis (5. stercoralis) hyperinfection.METHODS: Over a period of 23 years (1984-2006), we investigated 25 patients with 5. stercoralis hyperinfection who had had an esophagogastroduodenoscopy before undergoing treatment for strongyloidiasis. The clinical and endoscopic findings were analyzed retrospectively.RESULTS: Twenty-four (96%) of the patients investigated were under immunocompromised condition which was mainly due to a human T lymphotropic virus type 1 (HTLV-1) infection. The abnormal endoscopic findings, mainly edematous mucosa, white villi and erythematous mucosa, were observed in 23 (92%) patients. The degree of duodenitis including villous atrophy/destruction and inflammatory cell infiltration corresponded to the severity of the endoscopic findings. The histopathologic yield for identifying larvae was 71.4% by duodenal biopsy. The endoscopic findings of duodenitis were more severe in patients whose biopsies were positive for larvae than those whose biopsies were negative (Endoscopic severity score: 4.86 ± 2.47 vs 2.71 ± 1.38, P < 0.05).CONCLUSION: Our study clearly demonstrates that, in addition to stool analysis, endoscopic observation and biopsies are very important. We also emphasize that 5. stercoralis and HTLV-1 infections should be ruled out before immunosuppressive therapy is administered in endemic regions. |
| |
Keywords: | Strongyloides stercoralis Strongyloidiasis Hyperinfection Endoscopy Histopathology Duodenum |
本文献已被 维普 万方数据 PubMed 等数据库收录! |
|