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Disseminated strongyloidiasis in nephrotic syndrome
J Morimoto1, H Kaneoka, Y Sasatomi
1Kidney Center, Fukuoka University Hospital, Second Department of Pathology, School of Medicine, Fukuoka University, Japan.
Clinical Nephrology
|May 31, 2002
Summary
Disseminated strongyloidiasis caused a fatal outcome in an immunocompromised patient with minimal-change nephrotic syndrome. Autopsy revealed massive Strongyloides stercoralis infestation, suggesting a role in nephrotic syndrome exacerbation.
Area of Science:
- Infectious Diseases
- Nephrology
- Parasitology
Background:
- Strongyloides stercoralis is endemic in Japan's Amami and Ryukyu Islands.
- Systemic strongyloidiasis is a severe complication in immunocompromised individuals.
Observation:
- A 60-year-old patient with minimal-change nephrotic syndrome (MCNS) presented without eosinophilia or HTLV-I infection.
- Corticosteroid treatment for MCNS preceded the development of disseminated strongyloidiasis.
Findings:
- The patient experienced systemic purpura, ileus, respiratory distress, malabsorption, pancytopenia, pulmonary hemorrhage, and sepsis.
- Autopsy confirmed massive Strongyloides stercoralis infestation.
Implications:
- Strongyloides stercoralis larvae may act as a pathomechanism or exacerbating factor in nephrotic syndrome within endemic regions.
- This case highlights the critical need for vigilance regarding strongyloidiasis in immunocompromised patients, even without typical indicators.
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