1921
Volume 99, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

is the main etiological agent of human strongyloidiasis. Severe strongyloidiasis is commonly associated to alcoholism, corticostereoid use, and human T cell lymphotropic virus type 1 (HTLV-1) coinfection. Herein, we report a case of a 13-year-old boy coinfected with and HTLV-1, excreting several parasitic forms in the stool. The parasitological examination of his feces showed a large amount of filariform (about 3,000 larvae per gram of feces) and rhabditiform larvae (about 2,000 larvae per gram of feces). In addition, free-living adult females (about 50 parasites per gram of feces) and eggs (about 60 eggs per gram of feces) were detected. The main laboratory findings pointed to high immunoglobulin E (IgE) levels (228 UI/mL) and eosinophila (11.6%). The patient was treated with three courses of ivermectin (200 µg/kg twice, 2 weeks apart), achieving the parasitological cure. An increase of about 19 times in interleucin (IL)-17 level was observed following the parasitological cure, in addition to a decrease in the white blood cell, eosinophil counts, and IgE levels. This is the first case report, to our knowledge, in which an adult free-living female was described in human feces and where an increase in IL-17 levels after treatment in a HTLV-1 coinfected individual was observed. This finding raises the need for further studies about IL-17 immunomodulation in and HTLV-1 coinfected patients.

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References

  1. Nutman TB, 2017. Human infection with Strongyloides stercoralis and other related Strongyloides species. Parasitology 144: 263273.
    [Google Scholar]
  2. De Souza JN, Machado PR, Teixeira MC, Soares NM, 2014. Recurrence of Strongyloides stercoralis infection in a patient with Hansen’s disease: a case report. Lepr Rev 85: 5862.
    [Google Scholar]
  3. Zammarchi L, Montagnani F, Tordini G, Gotuzzo E, Bisoffi Z, Bartoloni A, Luca AD, 2015. Persistent strongyloidiasis complicated by recurrent meningitis in an HTLV seropositive peruvian migrant resettled in Italy. Am J Trop Med Hyg 92: 12571260.
    [Google Scholar]
  4. Willems L et al., 2017. Reducing the global burden of HTLV-1 infection: an agenda for research and action. Antiviral Res 137: 4148.
    [Google Scholar]
  5. Carvalho EM, Da Fonseca Porto A, 2004. Epidemiological and clinical interaction between HTLV-1 and Strongyloides stercoralis. Parasite Immunol 26: 487497.
    [Google Scholar]
  6. Porto MAF, Muniz A, Oliveira Júnior J, Carvalho EM, 2002. Clinical and immunological consequences of the association between HTLV-1 and strongyloidiasis. Rev Soc Bras Med Trop 35: 641649.
    [Google Scholar]
  7. Cabral AC, Iñiguez AM, Moreno T, Bóia MN, Carvalho-Costa FA, Cabral AC, Iñiguez AM, Moreno T, Bóia MN, Carvalho-Costa FA, 2015. Clinical conditions associated withintestinal strongyloidiasis in Rio de Janeiro, Brazil. Rev Soc Bras Med Trop 48: 321325.
    [Google Scholar]
  8. et al., 2016. Association between Strongyloides stercoralis infection and cortisol secretion in alcoholic patients. Acta Trop 154: 133138.
    [Google Scholar]
  9. Viney M, 2017. Strongyloides. Parasitology 144: 259262.
    [Google Scholar]
  10. Porto AF, Neva FA, Bittencourt H, Lisboa W, Thompson R, Alcântara L, Carvalho EM, 2001. HTLV-1 decreases Th2 type of immune response in patients with strongyloidiasis. Parasite Immunol 23: 503507.
    [Google Scholar]
  11. Weatherhead JE, Mejia R, 2014. Immune response to infection with Strongyloides stercoralis in patients with infection and hyperinfection. Curr Trop Med Rep 1: 229233.
    [Google Scholar]
  12. de Souza JN, Teixeira MCA, Soares NM, 2015. Associação entre hiperinfecção por Strongyloides stercoralis e HTLV-1: um relato de caso. Rev Ciênc Médicas E Biológicas 13: 427430.
    [Google Scholar]
  13. Negrão-Corrêa D, 2001. Importance of immunoglobulin E (IgE) in the protective mechanism against gastrointestinal nematode infection: looking at the intestinal mucosae. Rev Inst Med Trop São Paulo 43: 291299.
    [Google Scholar]
  14. Silva MLS et al., 2017. Influence of parasite load on the diagnosis and occurrence of eosinophilia in alcoholic patients infected with Strongyloides stercoralis. J Helminthol 28: 15.
    [Google Scholar]
  15. Domingos JA, Soares LS, Bandeira LM, Bonin CM, Vicente ACP, Zanella L, Puga MAM, Tozetti IA, Motta-Castro ARC, Cunha RV, 2017. Cytokine profile and proviral load among Japanese immigrants and non-Japanese infected with HTLV-1 in a non-endemic area of Brazil. PLoS One 12: e0174869.
    [Google Scholar]
  16. Dodon MD, Li Z, Hamaia S, Gazzolo L, 2004. Tax protein of human T-cell leukaemia virus type 1 induces interleukin 17 gene expression in T cells. J Gen Virol 85: 19211932.
    [Google Scholar]
  17. Santos SB, Oliveira P, Luna T, Souza A, Nascimento M, Siqueira I, Tanajura D, Muniz AL, Glesby MJ, Carvalho EM, 2012. Immunological and viral features in patients with overactive bladder associated with human T-cell lymphotropic virus type 1 infection. J Med Virol 84: 18091817.
    [Google Scholar]
  18. Leal FE et al., 2013. Expansion in CD39+ CD4+ immunoregulatory t cells and rarity of Th17 cells in HTLV-1 infected patients is associated with neurological complications. PLoS Negl Trop Dis 7: e2028.
    [Google Scholar]
  19. Barrett J, Broderick C, Soulsby H, Wade P, Newsholme W, 2016. Subcutaneous ivermectin use in the treatment of severe Strongyloides stercoralis infection: two case reports and a discussion of the literature. J Antimicrob Chemother 71: 220225.
    [Google Scholar]
  20. Bisoffi Z, Buonfrate D, Angheben A, Boscolo M, Anselmi M, Marocco S, Monteiro G, Gobbo M, Bisoffi G, Gobbi F, 2011. Randomized clinical trial on ivermectin versus thiabendazole for the treatment of strongyloidiasis. PLoS Negl Trop Dis 5: e1254.
    [Google Scholar]
  21. Suputtamongkol Y, Premasathian N, Bhumimuang K, Waywa D, Nilganuwong S, Karuphong E, Anekthananon T, Wanachiwanawin D, Silpasakorn S, 2011. Efficacy and safety of single and double doses of ivermectin versus 7-day high dose albendazole for chronic strongyloidiasis. PLoS Negl Trop Dis 5: e1044.
    [Google Scholar]
  22. Zaha O, Hirata T, Kinjo F, Saito A, Fukuhara H, 2002. Efficacy of ivermectin for chronic strongyloidiasis: two single doses given 2 weeks apart. J Infect Chemother 8: 9498.
    [Google Scholar]
  23. Zaha O, Hirata T, Uchima N, Kinjo F, Saito A, 2004. Comparison of anthelmintic effects of two doses of ivermectin on intestinal strongyloidiasis in patients negative or positive for anti-HTLV-1 antibody. J Infect Chemother 10: 348351.
    [Google Scholar]
  24. Kinjo T, Nabeya D, Nakamura H, Haranaga S, Hirata T, Nakamoto T, Atsumi E, Fuchigami T, Aoki Y, Fujita J, 2015. Acute respiratory distress syndrome due to Strongyloides stercoralis infection in a patient with cervical cancer. Intern Med Tokyo Jpn 54: 8387.
    [Google Scholar]
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  • Received : 11 May 2018
  • Accepted : 19 Aug 2018
  • Published online : 01 Oct 2018
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