Parasites, Hosts and Diseases

  • 제55권4호
  • /
  • Pages.391-398
  • /
  • 2017
  • /
  • 2982-5164(pISSN)
  • /
  • 1738-0006(eISSN)
대한기생충학·열대의학회 (The Korea Society for Parasitology and Tropical Medicine)
권호 표지
DOI QR코드

DOI QR Code

Hookworm Infection: A Neglected Cause of Overt Obscure Gastrointestinal Bleeding

  • Wei, Kun-Yan (Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University) ;
  • Yan, Qiong (Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University) ;
  • Tang, Bo (Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University) ;
  • Yang, Shi-Ming (Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University) ;
  • Zhang, Peng-Bing (Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University) ;
  • Deng, Ming-Ming (Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University) ;
  • Lu, Mu-Han (Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University)
  • 투고 : 2017.05.28
  • 심사 : 2017.06.23
  • 발행 : 2017.08.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Hookworm infections are widely prevalent in tropical and subtropical areas, especially in low income regions. In the body, hookworms parasitize the proximal small intestine, leading to chronic intestinal hemorrhage and iron deficiency anemia. Occasionally, hookworms can cause overt gastrointestinal bleeding, but this is often ignored in heavily burdened individuals from endemic infectious areas. A total of 424 patients with overt obscure gastrointestinal bleeding were diagnosed by numerous blood tests or stool examinations as well as esophagogastroduodenoscopy, colonoscopy, capsule endoscopy or double-balloon enteroscopy. All of the patients lived in hookworm endemic areas and were not screened for hookworm infection using sensitive tests before the final diagnosis. The patients recovered after albendazole treatment, blood transfusion, and iron replacement, and none of the patients experienced recurrent bleeding in the follow-up. All the 31 patients were diagnosed with hookworm infections without other concomitant bleeding lesions, a rate of 7.3% (31/424). Seventeen out of 227 patients were diagnosed with hookworm infections in the capsule endoscopy (CE), and 14 out of 197 patients were diagnosed with hookworm infections in the double balloon enteroscopy (DBE). Hookworm infections can cause overt gastrointestinal bleeding and should be screened in patients with overt obscure gastrointestinal bleeding (OGIB) in endemic infectious areas with sensitive methods. Specifically, the examination of stool specimens is clinically warranted for most patients, and the proper examination for stool eggs relies on staff's communication.

키워드

참고문헌

  1. Raju GS, Gerson L, Das A, Lewis B. American Gastroenterological Association (AGA) Institute medical position statement on obscure gastrointestinal bleeding. Gastroenterology 2007; 133: 1694-1696. https://doi.org/10.1053/j.gastro.2007.06.008
  2. American Gastroenterological Association Medical Position Statement: guidelines on intestinal ischemia. Gastroenterology 2000; 118: 951-953. https://doi.org/10.1016/S0016-5085(00)70182-X
  3. Steinmann P, Du ZW, Wang LB, Wang XZ, Jiang JY, Li LH, Marti H, Zhou XN, Utzinger J. Extensive multiparasitism in a village of Yunnan province, People's Republic of China, revealed by a suite of diagnostic methods. Am J Trop Med Hyg 2008; 78: 760-769.
  4. Liao Z, Gao R, Li F, Xu C, Zhou Y, Wang JS, Li ZS. Fields of applications, diagnostic yields and findings of OMOM capsule endoscopy in 2400 Chinese patients. World J Gastroenterol 2010; 16: 2669-2676. https://doi.org/10.3748/wjg.v16.i21.2669
  5. Lintermans JP. Severe intestinal bleeding leading to exploratory laparotomy in an infant with hookworm infection. Clin Pediatr (Phila) 1976; 15: 1073-1074. https://doi.org/10.1177/000992287601501117
  6. Rosenblatt JE. Clinical importance of adequately performed stool ova and parasite examinations. Clin Infect Dis 2006; 42: 979-980. https://doi.org/10.1086/500943
  7. Maxwell C, Hussain R, Nutman TB, Poindexter RW, Little MD, Schad GA, Ottesen EA. The clinical and immunologic responses of normal human volunteers to low dose hookworm (Necator americanus) infection. Am J Trop Med Hyg 1987; 37: 126-134. https://doi.org/10.4269/ajtmh.1987.37.126
  8. Goenka MK, Majumder S, Kumar S, Sethy PK, Goenka U. Single center experience of capsule endoscopy in patients with obscure gastrointestinal bleeding. World J Gastroenterol 2011; 17: 774-778. https://doi.org/10.3748/wjg.v17.i6.774
  9. Budhathoki S, Shah D, Bhurtyal KK, Amatya R, Dutta AK. Hookworm causing melaena and severe anaemia in early infancy. Ann Trop Paediatr 2008; 28: 293-296. https://doi.org/10.1179/146532808X375468
  10. Zheng Q, Chen Y, Zhang HB, Chen JX, Zhou XN. The control of hookworm infection in China. Parasit Vectors 2009; 2: 44. https://doi.org/10.1186/1756-3305-2-44
  11. Diemert DJ, Bethony JM, Hotez PJ. Hookworm vaccines. Clin Infect Dis 2008; 46: 282-288. https://doi.org/10.1086/524070
  12. Hotez PJ, Bethony J, Bottazzi ME, Brooker S, Buss P. Hookworm: "the great infection of mankind". PLoS Med 2005; 2: e67. https://doi.org/10.1371/journal.pmed.0020067
  13. Kelley PW, Takafuji ET, Wiener H, Milhous W, Miller R, Thompson NJ, Schantz P, Miller RN. An outbreak of hookworm infection associated with military operations in Grenada. Mil Med 1989; 154: 55-59. https://doi.org/10.1093/milmed/154.2.55
  14. Chen YY, Soon MS. Endoscopic diagnosis of hookworm infection that caused intestinal bleeding. Gastrointest Endosc 2005; 62: 142. https://doi.org/10.1016/S0016-5107(05)00515-8
  15. Roche M, Perez-Gimenez ME, Layrisse M, Di Prisco ME. Study of urinary and fecal excretion of radioactive chromium Cr51 in man; its use in the measurement of intestinal blood loss associated with hookworm infection. J Clin Invest 1957; 36: 1183-1192. https://doi.org/10.1172/JCI103514
  16. Brooker S, Bethony J, Hotez PJ. Human hookworm infection in the 21st century. Adv Parasitol 2004; 58: 197-288.
  17. de Silva NR, Brooker S, Hotez PJ, Montresor A, Engels D, Savioli L. Soil-transmitted helminth infections: updating the global picture. Trends Parasitol 2003; 19: 547-551. https://doi.org/10.1016/j.pt.2003.10.002
  18. Hotez PJ, Brooker S, Bethony JM, Bottazzi ME, Loukas A, Xiao S. Hookworm infection. N Engl J Med 2004; 351: 799-807. https://doi.org/10.1056/NEJMra032492
  19. Branda JA, Lin TY, Rosenberg ES, Halpern EF, Ferraro MJ. A rational approach to the stool ova and parasite examination. Clin Infect Dis 2006; 42: 972-978. https://doi.org/10.1086/500937
  20. Hochedez P, Caumes E. Hookworm-related cutaneous larva migrans. J Travel Med 2007; 14: 326-333. https://doi.org/10.1111/j.1708-8305.2007.00148.x

피인용 문헌

  1. Intestinal hookworm infestation causing chronic anaemia vol.12, pp.1, 2017, https://doi.org/10.1136/bcr-2018-228120
  2. Effect of Ancylostoma ceylanicum hookworm platelet inhibitor on platelet adhesion and peripheral blood mononuclear cell proliferation vol.119, pp.6, 2017, https://doi.org/10.1007/s00436-020-06678-4
  3. Evaluation of Hookworm Diagnosis Techniques from Patients in Debre Elias and Sanja Districts of the Amhara Region, Ethiopia vol.2021, pp.None, 2017, https://doi.org/10.1155/2021/6682330