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Am J Trop Med Hyg ; 99(6): 1583-1586, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30277207

RESUMEN

Strongyloides stercoralis 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 S. stercoralis 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 S. stercoralis adult free-living female was described in human feces and where an increase in IL-17 levels after Strongyloides treatment in a HTLV-1 coinfected individual was observed. This finding raises the need for further studies about IL-17 immunomodulation in S. stercoralis and HTLV-1 coinfected patients.


Asunto(s)
Heces/parasitología , Infecciones por HTLV-I/diagnóstico , Virus Linfotrópico T Tipo 1 Humano/inmunología , Strongyloides stercoralis/inmunología , Estrongiloidiasis/diagnóstico , Adolescente , Animales , Antihelmínticos/uso terapéutico , Brasil , Coinfección , Femenino , Infecciones por HTLV-I/inmunología , Infecciones por HTLV-I/patología , Virus Linfotrópico T Tipo 1 Humano/aislamiento & purificación , Humanos , Inmunoglobulina E/biosíntesis , Interleucina-17/biosíntesis , Ivermectina/uso terapéutico , Larva/inmunología , Masculino , Recuento de Huevos de Parásitos , Strongyloides stercoralis/aislamiento & purificación , Estrongiloidiasis/tratamiento farmacológico , Estrongiloidiasis/inmunología , Estrongiloidiasis/patología , Cigoto/inmunología
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