严重的类圆线虫病和系统性血管炎：合并症、关联还是两者兼有？基于病例的综述。

Severe strongyloidiasis and systemic vasculitis: comorbidity, association or both? Case-based review.

机构信息

Clinic of Allergology and Immunology, Clinical Center of Serbia, Belgrade, Serbia.

School of Medicine, University of Belgrade, Belgrade, Serbia.

出版信息

Rheumatol Int. 2018 Dec;38(12):2315-2321. doi: 10.1007/s00296-018-4178-y. Epub 2018 Oct 23.

DOI:10.1007/s00296-018-4178-y

PMID:30353268

Abstract

A possible association between strongyloidiasis and systemic vasculitis is rarely reported in the literature. We report the case of a patient with severe strongyloidiasis and an angiographic finding consistent with polyarteritis nodosa. Diagnosis of strongyloidiasis was made by finding of larvae and adult parasites in samples of the upper gastrointestinal tract mucosa and stool. The patient was treated with albendazole, ivermectin and corticosteroid withdrawal. This therapy led to the resolution of symptoms, with repeated stool samples negative for S. stercoralis. However, the clinical course was complicated with pulmonary tuberculosis. Despite tuberculostatic therapy and supportive measures, a lethal outcome occurred. The report is followed by a focused review of the available literature on the association of strongyloidiasis and systemic vasculitis.

摘要

文献中很少有关于寄生虫感染（如 Strongyloides 感染）与系统性血管炎之间关联的报道。我们报告了一例重症 Strongyloides 感染合并符合结节性多动脉炎的血管造影表现的患者。通过对上消化道黏膜和粪便样本中幼虫和成虫寄生虫的发现，诊断为 Strongyloides 感染。使用阿苯达唑、伊维菌素和皮质类固醇停药治疗。该治疗方案导致症状缓解，重复的粪便样本中均未检出 S. stercoralis。然而，该患者的临床病程复杂，并发肺结核。尽管进行了抗结核治疗和支持性治疗，但最终仍导致死亡。本报告随后对寄生虫感染（如 Strongyloides 感染）与系统性血管炎之间关联的现有文献进行了重点回顾。