Parasites, Hosts and Diseases

The Korea Society for Parasitology and Tropical Medicine (대한기생충학·열대의학회)
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Hookworm Infection Caused Acute Intestinal Bleeding Diagnosed by Capsule: A Case Report and Literature Review

  • Tan, Xia (Department of Nephrology, The Second Xiangya Hospital of Central South University, Renal Research Institute of Central South University, Key Laboratory of Kidney Disease and Blood Purification in Hunan) ;
  • Cheng, Meichu (Department of Nephrology, The Second Xiangya Hospital of Central South University, Renal Research Institute of Central South University, Key Laboratory of Kidney Disease and Blood Purification in Hunan) ;
  • Zhang, Jie (Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Renal Research Institute of Central South University, Key Laboratory of Kidney Disease and Blood Purification in Hunan) ;
  • Chen, Guochun (Department of Nephrology, The Second Xiangya Hospital of Central South University, Renal Research Institute of Central South University, Key Laboratory of Kidney Disease and Blood Purification in Hunan) ;
  • Liu, Di (Department of Nephrology, The Second Xiangya Hospital of Central South University, Renal Research Institute of Central South University, Key Laboratory of Kidney Disease and Blood Purification in Hunan) ;
  • Liu, Yexin (Department of Nephrology, The Second Xiangya Hospital of Central South University, Renal Research Institute of Central South University, Key Laboratory of Kidney Disease and Blood Purification in Hunan) ;
  • Liu, Hong (Department of Nephrology, The Second Xiangya Hospital of Central South University, Renal Research Institute of Central South University, Key Laboratory of Kidney Disease and Blood Purification in Hunan)
  • Received : 2017.05.02
  • Accepted : 2017.06.19
  • Published : 2017.08.31
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Abstract

Hookworm infections are rare causes of acute gastrointestinal bleeding. We report a middle aged man with primary nephrotic syndrome and pulmonary embolism. During the treatment with steroids and anticoagulants, the patient presented acute massive hemorrhage of the gastrointestinal tract. The results of gastroscopy showed red worms in the duodenum. Colonoscopy and CT angiogram of abdomen were unremarkable. Capsule endoscopy revealed fresh blood and multiple hookworms in the jejunum and ileum. Hookworms caused the acute intestinal bleeding. The patient responded well to albendazole. Hematochezia was markedly ameliorated after eliminating the parasites. Hence, hookworm infection should be considered in the differential diagnosis of a patient with obscure gastrointestinal bleeding. Capsule endoscopy may offer a better means of diagnosis for intestinal hookworm infections.

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