<i>Strongyloides stercoralis</i> colitis in a patient positive for human T-cell leukaemia virus with rheumatoid arthritis during an anti-rheumatic therapy: a case report

Hashiba, Yayoi; Umekita, Kunihiko; Matsuda, Hiroyuki; Kawano, Atsuko; Nagayasu, Eiji; Maruyama, Haruhiko; Hidaka, Toshihiko; Okayama, Akira

doi:10.1080/24725625.2020.1808304

Cited by 7 publications

(4 citation statements)

References 34 publications

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“…However, there is little information on strongyloidiasis in patients undergoing biological treatment. Most of the published cases are associated with the use of anti-TNF therapy (etanercept [ 42 ], infliximab [ 43 ], adalimumab [ 44 ] or golimumab [ 45 ], and attributed to the accumulation of circulating CD4 T helper type 1 lymphocytes, with a corresponding decrease in T helper type 2 cells [ 46 ]. A smaller number of cases has been reported in patients receiving monoclonal antibodies against IL-6R (tocilizumab) [ 47 ], anti-CD20 (rituximab) [ 48 ] or anti-CD52 (alentuzumab) [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of Strongyloides stercoralis in Patients about to Receive Immunosuppressive Treatment in Gran Canaria (Spain)

et al. 2023

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Strongyloides stercoralis infection is generally asymptomatic or mildly symptomatic, but in the immunosuppressed host, it is associated with more severe and complicated forms with a worse prognosis. S. stercoralis seroprevalence was studied in 256 patients before receiving immunosuppressive treatment (before kidney transplantation or starting biological treatments). As a control group, serum bank data of 642 individuals representative of the population of the Canary Islands were retrospectively analyzed. To avoid false positives due to cross-reactivity with other similar helminth antigens present in the study area, IgG antibodies to Toxocara spp. and Echinococcus spp. were evaluated in cases positive for Strongyloides. The data show this is a prevalent infection: 1.1% of the Canarian population, 2.38% of Canarian individuals awaiting organ transplants and 4.8% of individuals about to start biological agents. On the other hand, strongyloidiasis can remain asymptomatic (as observed in our study population). There are no indirect data, such as country of origin or eosinophilia, to help raise suspicion of the disease. In summary, our study suggests that screening for S. stercoralis infection should be performed in patients who receive immunosuppressive treatment for solid organ transplantation or biological agents, in line with previous publications.

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Section: Discussionmentioning

confidence: 99%

Seroprevalence of Strongyloides stercoralis in Patients about to Receive Immunosuppressive Treatment in Gran Canaria (Spain)

et al. 2023

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“…Hashiba et al reported a case of HTLV-1-positive RA patients who developed S. stercoralis colitis after administration of a TNF inhibitor [ 77 ]. Recently, a HTLV-1 RA cohort study found a higher incidence of serious infections requiring hospitalization in HTLV-1-positive RA patients than in HTLV-1-negative RA patients [ 68 ].…”

Section: Are There Any Differences In Clinical Features Between Htlv-...mentioning

confidence: 99%

Effect of HTLV-1 Infection on the Clinical Course of Patients with Rheumatoid Arthritis

Umekita

2022

Viruses

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Human T-cell leukemia virus type 1 (HTLV-1) is the causative agent of adult T-cell leukemia/lymphoma (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). The effects of HTLV-1 on health are not fully elucidated. Epidemiological studies have shown that the prevalence of HTLV-1 infection is high in patients with rheumatic diseases. The prevalence of comorbidities, such as Sjögren’s syndrome and rheumatoid arthritis (RA), is higher in patients with HAM/TSP than the in general population. Studies have shown the effects of HTLV-1-infection on the clinical course of RA. Major questions on the association between HTLV-1 infection and RA: (1) Is it possible that HTLV-1 infection causes RA? (2) Do patients with RA who are infected with HTLV-1 have different clinical features? (3) Are immunosuppressants associated with an increased prevalence of HAM/TSP or ATL in RA patients with HTLV-1 infection? Is ATL an immunosuppressive therapy-associated lymphoproliferative disorder? No large-scale studies have investigated the incidence of ATL in patients with RA. However, several studies have reported the development of ATL in patients with RA who have HTLV-1 infection. This review aimed to shed light on the association between HTLV-1 infection and RA and summarize the unmet medical needs of RA patients with HTLV-1 infection.

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“…In recent times, it has been observed that there is an increased risk of disseminated strongyloidiasis in patients with RA, taking immune system suppressing therapies [27][28][29]. A study in Turkey has identified patients with RA as being more at risk of developing strongyloidiasis than patients suffering from other immune-deficiency syndromes living in areas where strongyloid infections are endemic [30].…”

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confidence: 99%

Evaluation of therapeutic potential of ivermectin against complete Freund's adjuvant‐induced arthritis in rats: Involvement of inflammatory mediators

Khan

Akhtar

Naseem

et al. 2023

Fundamemntal Clinical Pharma

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Rheumatoid arthritis is a chronic systemic inflammatory disease with genetic manifestations. According to recently published case reports, patients taking corticosteroid medication for the management of rheumatoid arthritis develop strongloidiasis and are at high risk of developing associated infections. This study explored the antiarthritic role of ivermectin, a drug used in the treatment of strongyloides and to compare its results with dexamethasone. Thirty‐two male Wistar rats were randomly divided into four groups: control, diseased, dexamethasone, and ivermectin groups. Rheumatoid arthritis in all rats except the control group was induced by using complete Freund's adjuvant. After 7 days of rheumatoid arthritis induction, animals were treated with dexamethasone 5 mg/kg and ivermectin 6 mg/kg. Body weight, visual arthritic score, total leukocyte count, differential leukocyte count, proinflammatory genes, and histopathological findings were used to assess the effects of ivermectin on rheumatoid arthritis. Treatment with ivermectin showed a significant reduction in inflammatory cells levels, body weight, and visual arthritic score, indicating an improvement in the degree of inflammation as compared with the diseased group. Treatment with ivermectin and dexamethasone significantly reduced the augmentation in the mRNA expression levels of IL‐17, TLR‐2, TNF, and NF‐κB as a result of arthritic development. Ivermectin treatment also showed a significant reduction in the severity of inflammation and destruction of joints and showed comparable effects to dexamethasone, a corticosteroid used for the treatment of rheumatoid arthritis. Ivermectin has significant antiarthritic properties and can be a novel treatment agent for the management of rheumatoid arthritis patients suffering from strongyloidiasis.

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Strongyloides stercoralis colitis in a patient positive for human T-cell leukaemia virus with rheumatoid arthritis during an anti-rheumatic therapy: a case report

Abstract: Okayama (2021) Strongyloides stercoralis colitis in a patient positive for human T-cell leukaemia virus with rheumatoid arthritis during an anti-rheumatic therapy: a case report,

Cited by 7 publications

References 34 publications

Seroprevalence of Strongyloides stercoralis in Patients about to Receive Immunosuppressive Treatment in Gran Canaria (Spain)

Seroprevalence of Strongyloides stercoralis in Patients about to Receive Immunosuppressive Treatment in Gran Canaria (Spain)

Effect of HTLV-1 Infection on the Clinical Course of Patients with Rheumatoid Arthritis

Evaluation of therapeutic potential of ivermectin against complete Freund's adjuvant‐induced arthritis in rats: Involvement of inflammatory mediators

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