Tan Xia, Cheng Meichu, Zhang Jie, Chen Guochun, Liu Di, Liu Yexin, Liu Hong
Department of Nephrology, The Second Xiangya Hospital of Central South University, Renal Research Institute of Central South University, Key Laboratory of Kidney Disease and Blood Purification in Hunan, Changsha 410011, Hunan, P. R. China.
Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Renal Research Institute of Central South University, Key Laboratory of Kidney Disease and Blood Purification in Hunan, Changsha 410011, Hunan, P. R. China.
Korean J Parasitol. 2017 Aug;55(4):417-420. doi: 10.3347/kjp.2017.55.4.417. Epub 2017 Aug 31.
Hookworm infections are rare causes of acute gastrointestinal bleeding. We report a middle aged man with primary nephrotic syndrome and pulmonary embolism. During the treatment with steroids and anticoagulants, the patient presented acute massive hemorrhage of the gastrointestinal tract. The results of gastroscopy showed red worms in the duodenum. Colonoscopy and CT angiogram of abdomen were unremarkable. Capsule endoscopy revealed fresh blood and multiple hookworms in the jejunum and ileum. Hookworms caused the acute intestinal bleeding. The patient responded well to albendazole. Hematochezia was markedly ameliorated after eliminating the parasites. Hence, hookworm infection should be considered in the differential diagnosis of a patient with obscure gastrointestinal bleeding. Capsule endoscopy may offer a better means of diagnosis for intestinal hookworm infections.
钩虫感染是急性胃肠道出血的罕见病因。我们报告一名患有原发性肾病综合征和肺栓塞的中年男性。在使用类固醇和抗凝剂治疗期间，该患者出现了急性大量胃肠道出血。胃镜检查结果显示十二指肠内有红色蠕虫。结肠镜检查和腹部CT血管造影均无异常。胶囊内镜检查发现空肠和回肠内有新鲜血液和多条钩虫。钩虫导致了急性肠道出血。该患者使用阿苯达唑治疗效果良好。清除寄生虫后便血明显改善。因此，对于不明原因胃肠道出血的患者，鉴别诊断时应考虑钩虫感染。胶囊内镜检查可能为肠道钩虫感染提供更好的诊断方法。
