Parasites, Hosts and Diseases

The Korea Society for Parasitology and Tropical Medicine (대한기생충학·열대의학회)
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Strongyloidiasis in a Diabetic Patient Accompanied by Gastrointestinal Stromal Tumor: Cause of Eosinophilia Unresponsive to Steroid Therapy

  • Won, Eun Jeong (Department of Laboratory Medicine, Chonnam National University Hospital) ;
  • Jeon, Jin (Department of Allergy, Asthma and Clinical Immunology, Chonnam National University Medical School) ;
  • Koh, Young-Il (Department of Allergy, Asthma and Clinical Immunology, Chonnam National University Medical School) ;
  • Ryang, Dong Wook (Department of Laboratory Medicine, Chonnam National University Hospital)
  • Received : 2015.01.07
  • Accepted : 2015.02.25
  • Published : 2015.04.30
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Abstract

We report here a case of strongyloidiasis in a 72-year-old diabetic patient (woman) accompanied by gastrointestinal stromal tumor receiving imatinib therapy, first diagnosed as hypereosinophilic syndrome and treated with steroids for uncontrolled eosinophilia. She suffered from lower back pain and intermittent abdominal discomfort with nausea and diagnosed with gastrointestinal stromal tumor. After post-operative imatinib treatment eosinophilia persisted, so that steroid therapy was started under an impression of hypereosinophilic syndrome. In spite of 6 months steroid therapy, eosinophilia persisted. Stool examination was performed to rule out intestinal helminth infections. Rhabditoid larvae of Strongyloides stercoralis were detected and the patient was diagnosed as strongyloidiasis. This diagnosis was confirmed again by PCR. The patient was treated with albendazole for 14 days and her abdominal pain and diarrhea improved. This case highlights the need for thorough investigation, including molecular approaches, to test for strongyloidiasis before and during steroid therapies.

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References

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