Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
A case of strongyloidiasis hyperinfection during oral corticosteroid therapy associated with a nephrotic patient infected with HTLV-1
Makoto MitsunagaNaoko MiyauchiYurika AkiyamaShigeki Saima
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2003 Volume 40 Issue 4 Pages 397-401

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Abstract

There have been some reports of disseminated Strongyloidiasis associated with immunosuppressive therapy around the endemic area. We encountered an elderly patient with Strongyloidiasis hyperinfection during corticosteroid therapy. The case was a 75-year-old man, living in Tokunoshima, Kagoshima Prefecture, who had no remarkable past history. He visited a clinic because of exertional dyspnea and edema of the lower limbs. Laboratory examination showed renal dysfunction, microscopic hematuria and proteinuria. On December 2000, he was admitted to our hospital on a suspected diagnosis of rapidly progressive glomerulonephritis. Further examinations showed normal serum creatinine, severe microscopic hematuria and proteinuria of more than 3g per day. Although we wanted to determine a treatment based on a pathologic diagnosis, considered his age and severe kyphosis, he had 30mg of prednisolone as an empiric treatment. Strongyloides stercoralis were identified from his sputa and stool by microscopic investigation 21 days after initiation of corticosteroid therapy. Subsequently, 6mg of Ivermectin was given twice every two weeks. S. stercoralis were eradicated and his proteinuria improved. This case suggests that S. stercoralis could be the cause of urine abnormality.

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