Systemic vasculitis associated with Fasciola hepatica infection

Area of Science:

• Infectious Diseases
• Immunology
• Rheumatology

Background:

• Systemic vasculitis often presents with diverse organ involvement and can be idiopathic or secondary to infections.
• Distinguishing vasculitis secondary to parasitic infections from primary autoimmune vasculitis is crucial for appropriate management.

Observation:

• A 50-year-old male presented with severe systemic vasculitis affecting skin, kidneys, spleen, eyes, and neurological function.
• Initial investigations for primary vasculitis and other common infections were negative, and steroid treatment was ineffective.

Findings:

• Fasciola hepatica infection was confirmed via specific immunoglobulin G (IgG) antibodies detected by ELISA (OD 0.483) and high-titer complement fixation (1/80).
• Treatment with triclabendazole led to complete resolution of vasculitis symptoms and systemic manifestations within weeks.

Implications:

• This case highlights Fasciola hepatica as a previously unreported cause of systemic vasculitis.
• Early identification and targeted antiparasitic therapy can lead to a cure for this specific vasculitis presentation.