Atypical presentation of hepatic visceral larva migrans mimicking cancer and associated with ADAMTS13 deficiency-mediated thrombotic microangiopathy: A first report from Reunion Island

Bone marrow section revealed eosinophil infiltration (26%) with normal immunohistochemical profile of B and T cells. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) showed diffuse intense heterogeneous hypermetabolic activity in the liver standardized uptake value (S...

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Veröffentlicht in:PLoS neglected tropical diseases 2017-07, Vol.11 (7), p.e0005617-e0005617
Hauptverfasser: Bonnefond, Simon, Foucher, Aurélie, Zunic, Patricia, Hoarau, Gautier, Magnaval, Jean-François
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Sprache:eng
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Zusammenfassung:Bone marrow section revealed eosinophil infiltration (26%) with normal immunohistochemical profile of B and T cells. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) showed diffuse intense heterogeneous hypermetabolic activity in the liver standardized uptake value (SUV) max value = 10) but no primary tumor was seen (Fig 1C and 1E). Coombs test (IgG and C3d) was positive and renal function was normal. Because Evans syndrome or thrombotic microangiopathy (TMA) was suspected, we started a corticosteroid therapy of 60 mg (total dosage) per day. Since strongyloidiasis is endemic in La Réunion, a single 12-mg round of ivermectin was given before corticosteroid treatment in order to prevent a drug-induced hyperinfection. According to the so-called hygiene hypothesis and also the coevolution theory, it has been hypothesized that helminth infections could protect against autoimmune diseases, particularly by shaping and tuning the immune system during the early life [19]. [...]treatment of autoimmune diseases by helminth infections is being studied in clinical trials, even though there are immense conflicting data regarding the benefits versus harms of using live helminths [20,21].
ISSN:1935-2735
1935-2727
1935-2735
DOI:10.1371/journal.pntd.0005617