A Case of Protein Losing Enteropathy Due to Strongyloidiasis Yoshiaki Kata 1 1First Department of Internal Medicine, Nagoya Uriversity School of Medicine pp.701-706
Published Date 1970/6/25
DOI https://doi.org/10.11477/mf.1403111298
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 A 27-year-old man from Ishigakijima Island was hospitalized due to edema, weight loss and abdominal pain. On physical examination, distension of the upper abdomen, clubbed fingers and leg edema were noted. Radiologic examination of the upper gastrointestinal tract revealed a severe inflammatory change of the duodenum and the proximal part of the jejunum and moderate dilatation and thickening of the mucosal folds of the remaining segment of the small intestine. By the detection of the rhabditiform larvae of Strongyloides stereoralis in feces and duodenal fluid, these changes were considered to be produced by strongyloidiasis. Serum protein level was 4.0 g/dl, A/G ratio 0.36 and T. I. B. C. 116 μg/dl. Half-life of I. V. administered RIHSA was reduced to 3.9 days, fecal fat was 14 g daily and oral glucose tolerance test showed a diabetic curve. From these results, it was concluded that the patient had malabsorption and protein losing enteropathy due to strongyloidiasis. Soon after the treatment with thiabendazole (25 mg/kg body weight, twice daily for 2 days), gastrointestinal trouble disappeared without noticeable side reaction except transient minimal edema on legs. He rapidly gained weight and the results of examinations performed around 1 month after therapy were remarkably improved. Five months later were larvae again detected in feces without any symptom, and retreatment was done with doubled dosis of thiabendazole. Since no larvae had been found on repeated examinations of feces and duodenal fluid for 1 1/2 years thereafter, the patient was regarded as completely cured.

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