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由粪类圆线虫迁移至肺部引起的吕弗勒综合征:一例报告及文献综述

Loeffler's Syndrome Induced by the Transmigration of Strongyloides stercoralis to the Lungs: A Case Report and Literature Review.

作者信息

Singh Bhupinder, Verma Sakshi, Rashid Kanwal, Stoltzfus Mason T

机构信息

Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, New York, USA.

Medicine, Government Medical College, Amritsar, IND.

出版信息

Cureus. 2024 Dec 17;16(12):e75897. doi: 10.7759/cureus.75897. eCollection 2024 Dec.

Abstract

Loeffler's syndrome is a rare, benign respiratory disease usually associated with peripheral eosinophilia, first described by Wilhelm Loeffler in 1932. It is caused by the larvae of helminths such as hookworms, , and S that transmigrate through the lungs during the active phase of infection. We present a case of a 53-year-old man who complained of a productive cough with intermittent hemoptysis and left-sided posterior chest pain. Initial evaluation revealed ground-glass opacity in the left upper lobe on chest X-ray and computed tomography (CT) scan, with laboratory results suggestive of leukocytosis, eosinophilia, and elevated IgE levels. After ruling out other potential diagnoses, strongyloidiasis was suspected. Serology for was positive, and stool studies confirmed the presence of  larvae. The patient was started on ivermectin and followed up in the outpatient clinic. Repeat chest CT after one month showed resolution of the previously noted left upper lobe infiltrate. This case report aims to describe this rare instance of Loeffler's syndrome and provide an update on the epidemiology, risk factors, and association of strongyloidiasis with other diseases and medications.

摘要

吕弗勒综合征是一种罕见的良性呼吸道疾病,通常与外周嗜酸性粒细胞增多有关,于1932年由威廉·吕弗勒首次描述。它由钩虫等蠕虫的幼虫引起,这些幼虫在感染活跃期穿过肺部。我们报告一例53岁男性病例,该患者主诉有咳痰伴间歇性咯血及左侧后胸痛。初步评估显示胸部X线和计算机断层扫描(CT)显示左上叶磨玻璃影,实验室检查结果提示白细胞增多、嗜酸性粒细胞增多及免疫球蛋白E水平升高。排除其他潜在诊断后,怀疑为类圆线虫病。类圆线虫血清学检查呈阳性,粪便检查证实有类圆线虫幼虫。患者开始使用伊维菌素治疗,并在门诊随访。1个月后复查胸部CT显示先前左上叶浸润影消失。本病例报告旨在描述这一罕见的吕弗勒综合征病例,并提供关于类圆线虫病的流行病学、危险因素以及与其他疾病和药物的关联的最新信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4d5/11738083/b3cce5f1bd3c/cureus-0016-00000075897-i01.jpg

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