| Minimal change nephrotic syndrome in a patient with strongyloidiasis. | |
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MedLine Citation:
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PMID: 20224878 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Strongyloidiasis, a chronic infection caused by the intestinal parasite Strongyloides stercoralis, is prevalent in the Nansei Islands of Japan. Here, we report our findings on a case of strongyloidiasis complicated with steroid-resistant minimal change nephrotic syndrome in a 69-year-old male resident of Fukuoka Prefecture who had lived in Yakushima, one of the Nansei Islands, until age 15. In October 2006, he developed proteinuria and edema, and was diagnosed with minimal change nephrotic syndrome on the basis of the renal biopsy findings. Following treatment with prednisolone, the level of proteinuria decreased to 0.29 g/day by day 35. However, 5 days later (day 40), the patient developed persistent watery diarrhea and vomiting, leading to dehydration and malnutrition. Pneumonia and bacterial meningitis subsequently developed (day 146); filarial (infectious-type) and rhabditiform (noninfectious-type) S. stercoralis larvae were detected for the first time in the patient's sputum, gastric juice, feces, and urine. Although treatment with ivermectin was started immediately and the parasitosis responded to the treatment, the patient died of sepsis. Consequently, although strongyloidiasis is a rare infection except in endemic regions, it is essential to consider the possibility of this disease and begin treatment early for patients who have lived in endemic areas and who complain of unexplained diarrhea during steroid-induced or other immunosuppression. |
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Authors:
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Mieko Miyazaki; Masahito Tamura; Narutoshi Kabashima; Ryota Serino; Tatsuya Shibata; Tetsu Miyamoto; Yumi Furuno; Tetsuo Nishio; Jiro Ohara; Toshihiro Sakurai; Yutaka Otsuji |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2010-03-12 |
Journal Detail:
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Title: Clinical and experimental nephrology Volume: 14 ISSN: 1437-7799 ISO Abbreviation: Clin. Exp. Nephrol. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-03 Completed Date: 2010-11-22 Revised Date: 2011-07-28 |
Medline Journal Info:
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Nlm Unique ID: 9709923 Medline TA: Clin Exp Nephrol Country: Japan |
Other Details:
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Languages: eng Pagination: 367-71 Citation Subset: IM |
Affiliation:
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Second Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Animals Antiparasitic Agents / administration & dosage Biopsy Diarrhea / parasitology Edema / etiology Fatal Outcome Glucocorticoids / administration & dosage Humans Ivermectin / administration & dosage Kidney / pathology Male Nephrosis, Lipoid / drug therapy, parasitology*, pathology Prednisolone / administration & dosage Proteinuria / etiology Sepsis / parasitology Strongyloides stercoralis / isolation & purification* Strongyloidiasis / diagnosis, drug therapy, parasitology* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antiparasitic Agents; 0/Glucocorticoids; 50-24-8/Prednisolone; 70288-86-7/Ivermectin |
| Comments/Corrections | |
Comment In:
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Clin Exp Nephrol. 2011 Jun;15(3):448
[PMID:
21468622
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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