Document Detail

A case of giardiasis expressing severe systemic symptoms and marked hypereosinophilia.
MedLine Citation:
PMID:  20601107     Owner:  NLM     Status:  MEDLINE    
An 88-year-old Japanese woman was referred to our hospital due to a one-month history of face edema, aphagia, shortness of breath, and skin rush over almost her entire skin. She had no abdominal symptoms. Her peripheral blood count showed a white blood cell (WBC) count of 27.1x10(9)/L with 82.1% eosinophils. Serum non-specific Immunoglobulin E was within a normal range. Soluble interleukin-2 receptor was elevated to 4200U/mL. At first, her eosinophil count was so high that we suspected she had an eosinophilic leukemia or hypereosinophilic syndrome. After admission, cysts of Giardia duodenalis (G. duodenalis) were detected in the patient's feces by microscopic analysis, then she was diagnosed with giardiasis, and 750mg per day of metronidazole was administered for seven days. Her WBC count decreased to 6.0x10(9)/L with 10% eosinophils, and her systemic symptoms improved. At that time her serum IL-5 was within a normal range. A few months later, the patient again complained of skin rush, and G. duodenalis was once again found in her feces. Her serum IL-5 was elevated to 751pg/mL. Metronidazole was administered for two weeks, and her eosinophil count decreased. G. duodenalis is a protozoan parasite, and it is one of the most common waterborne transmission gastrointestinal parasites in the world. G. duodenalis rarely causes hypereosinophilia. To our knowledge, this is the first case report of giardiasis with extreme hypereosinophilia and severe systemic symptoms.
Yuhko Suzuki; Takeshi Nakamura; Masaharu Tokoro; Tomiteru Togano; Manabu Ohsaka; Mika Kohri; Yasuyoshi Hirata; Koji Miyazaki; Mikio Danbara; Ryouichi Horie; Ikuo Miura; Keisuke Sunakawa; Masaaki Higashihara
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-06-23
Journal Detail:
Title:  Parasitology international     Volume:  59     ISSN:  1873-0329     ISO Abbreviation:  Parasitol. Int.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-09     Completed Date:  2010-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708549     Medline TA:  Parasitol Int     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  487-9     Citation Subset:  IM    
Department of Hematology, Kitasato University School of Medicine, Kitasato, Sagamihara, Japan.
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MeSH Terms
Aged, 80 and over
Eosinophilia / diagnosis,  etiology*,  parasitology
Feces / parasitology
Giardia / classification,  isolation & purification*
Giardiasis / complications*,  diagnosis*,  parasitology
Interleukin-5 / blood
Reg. No./Substance:

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