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Severe hepatic involvement in visceral larva migrans
1Department of Gastroenterology, Silesian Medical School, Katowice, Poland. lakmus@poczta.wprost.pl
European Journal of Gastroenterology & Hepatology
|November 17, 2001
Summary
Visceral larva migrans, a parasitic infection, can cause severe liver disease in adults. Early diagnosis and treatment of toxocariasis are crucial for managing cholestatic hepatitis.
Area of Science:
- Hepatology
- Parasitology
- Infectious Diseases
Background:
- The liver's anatomical position predisposes it to protozoan and helminthic infections.
- Visceral larva migrans (VLM) from Toxocara canis is infrequently considered in adult cholestatic syndromes, particularly without hypereosinophilia.
Observation:
- A 74-year-old immunocompetent woman presented with fever, bronchospasm, erythema nodosum, weight loss, and jaundice.
- Liver biopsy revealed caseating granulomatous hepatitis with portal fibrosis and bile duct paucity.
- Computed tomography and laparoscopy showed mass lesions and perihepatitis.
Findings:
- A diagnosis of toxocariasis was confirmed by a positive enzyme-linked immunosorbent assay IgG test.
- Treatment with steroids and diethylcarbamazine resulted in clinical improvement and reduced anti-Toxocara canis antibody levels.
Implications:
- Visceral larva migrans can present as a debilitating cause of chronic liver disease.
- Toxocariasis should be suspected in febrile patients with unexplained cholestatic hepatitis.