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孕妇类圆线虫病综述

A Review on Strongyloidiasis in Pregnant Women.

作者信息

Wikman-Jorgensen Philip, Requena-Méndez Ana, Llenas-García Jara

机构信息

Internal Medicine Department, Hospital Universitario San Juan de Alicante-FISABIO, San Juan de Alicante, Alicante, Spain.

Barcelona Institute for Global Health (ISGlobal, Hospital Clinic-Universitat de Barcelona), Barcelona, Spain.

出版信息

Res Rep Trop Med. 2021 Sep 21;12:219-225. doi: 10.2147/RRTM.S282268. eCollection 2021.

Abstract

Strongyloidiasis is a parasitic infection distributed worldwide, with an estimated 614 million people infected. Strongyloidiasis usually presents asymptomatically or with aspecific and mild clinical symptoms, mainly cutaneous, respiratory, or gastrointestinal. Disseminated disease and hyperinfection syndrome are the most serious complications, have a high mortality rate, usually occur in immunosuppressed patients, and are particularly associated with the use of corticosteroids. Strongyloidiasis is the most neglected of the neglected diseases, and its occurrence in pregnancy has been neglected and understudied. In this review, we focus on the effects of strongyloidiasis during pregnancy and highlight the knowledge shortage and the need for more research on the subject. There are few studies addressing strongyloidiasis prevalence during pregnancy and hyperinfection incidence during pregnancy is practically unknown, with only isolated case reports published. Although data are scarce, the infection has been associated with developmental disabilities and anemia during pregnancy, while hyperinfection may cause both maternal and neonatal death. Data on the best screening and diagnostic strategies during pregnancy are lacking. There is insufficient evidence on ivermectin safety in pregnancy, complicating treatment recommendations.

摘要

类圆线虫病是一种遍布全球的寄生虫感染病,估计有6.14亿人感染。类圆线虫病通常无症状,或表现为非特异性的轻微临床症状,主要为皮肤、呼吸或胃肠道症状。播散性疾病和高度感染综合征是最严重的并发症,死亡率很高,通常发生在免疫抑制患者中,尤其与使用皮质类固醇有关。类圆线虫病是被忽视疾病中最受忽视的一种,其在妊娠期的发生一直被忽视且研究不足。在本综述中,我们重点关注类圆线虫病在妊娠期的影响,并强调这一领域的知识短缺以及对更多研究的需求。关于妊娠期类圆线虫病患病率的研究很少,妊娠期高度感染的发生率实际上也不清楚,仅有个别病例报告发表。尽管数据稀少,但该感染与妊娠期发育障碍和贫血有关,而高度感染可能导致孕产妇和新生儿死亡。缺乏关于妊娠期最佳筛查和诊断策略的数据。关于伊维菌素在妊娠期的安全性证据不足,使得治疗建议变得复杂。

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本文引用的文献

4
The Global Prevalence of Infection.感染的全球流行情况。
Pathogens. 2020 Jun 13;9(6):468. doi: 10.3390/pathogens9060468.
8
Safety of ivermectin during pregnancy.伊维菌素在孕期的安全性。
Lancet Glob Health. 2020 Mar;8(3):e338. doi: 10.1016/S2214-109X(19)30555-8.
10
Is ivermectin safe in pregnancy?伊维菌素在孕期使用安全吗?
Lancet Glob Health. 2020 Jan;8(1):e12-e13. doi: 10.1016/S2214-109X(19)30490-5.

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