上部消化管内視鏡検査で診断しえたズビニ鉤虫症の1例

Ancylostoma Duodenale Infection Diagnosed by Upper Gastrointestinal Endoscopy, Report of a Case

要旨　患者は75歳，女性．高度の貧血（Hb3.1g/dl）の精査のため入院し，上部消化管内視鏡検査で十二指腸に糸状の虫体を認め，回収した虫体よりズビニ鉤虫と診断した．輸血と駆虫薬pyrantel pamoateの投与で虫体，虫卵は消失し，貧血も改善した．本患者は過去2回，同様の貧血で検査を受けていたが原因は究明されておらず，原因不明の貧血を繰り返すような患者の診療に際しては本疾患も念頭に置いておく必要があると思われる．

　A 72-year-old woman was admitted to our hospital with severe anemia. A panendoscopic examination revealed reddish and whitish hookworms attached to the duodenal mucosa. A few of them were removed by biopsy forceps and were identified as Ancylostoma duodenale. The patient was transfused with 8 units of blood in total and was treated with 400mg of pyrantel pamoate per day for two days. After the treatment, her anemia improved and the hookworms completely disappeared. In the past, she had had a history of hospitalization in our and in another hospital two times due to severe anemia. She had undergone several examinations at those times, but no causative lesions had been detected.

　We should consider the possibility of hookworm disease when a patient is suffering from anemia with unknown etiology, and should try to discover the existence of hookworm eggs in the patients stool, especially by using the concentration method.

　1) Department of Radiology, Munakata Medical Association Hospital, Munakata, Japan

　2) Department of Internal Medicine, Munakata Medical Association Hospital, Munakata, Japan