<i>Strongyloides stercoralis</i> infection in patients with systemic lupus erythematosus: diagnosis and prevention of severe strongyloidiasis

Souza, Robson da Paixão de; Inês, Elizabete de Jesus; Santiago, Mittermayer B.; Teixeira, Márcia Cristina Aquino; Soares, Neci Matos

doi:10.1111/1756-185x.12644

Cited by 10 publications

(5 citation statements)

References 31 publications

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“…The similar rate of detection of S. stercoralis by direct faecal examination and by the APC method in our study contrasts with the finding of another study 35 and with literature reviews, 36,37 which suggested that APC increases detection yields by 1.6–6 times compared to traditional methods. However, APC is a stool-based method in which detection still depends on the output of larvae.…”

Section: Discussioncontrasting

confidence: 97%

Prevalence and risk factors of strongyloidiasis in patients with systemic lupus erythematosus in Southern Thailand

Juthong

Geater

Dekumyoy

et al. 2020

Lupus

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Background Strongyloidiasis can be fatal in systemic lupus erythematosus (SLE) patients, but few epidemiological studies have investigated the burden of this tropical disease among the SLE population. This study aimed to assess the prevalence and associated factors of strongyloidiasis among SLE patients in Southern Thailand. Methods A cross-sectional study was conducted on 180 SLE patients attending the Rheumatology Clinic at Songklanagarind Hospital. Stool specimens were collected and examined using the direct smear technique and agar plate culture technique. Serum anti- Strongyloides stercoralis IgG was measured by IgG-ELISA. Results The overall prevalence of strongyloidiasis by combined parasitologyl and/or serology was 15.6%. The prevalence of strongyloidiasis by parasitological methods was 2.2%. Positive parasitology and/or serology was associated with male sex and a SLE disease duration of less than two years. Conclusion Strongyloidiasis is highly prevalent among the SLE population. A combination of serological and parasitological methods increases the rate of diagnosis of strongyloidiasis in SLE patients.

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Section: Discussioncontrasting

confidence: 97%

Prevalence and risk factors of strongyloidiasis in patients with systemic lupus erythematosus in Southern Thailand

Juthong

Geater

Dekumyoy

et al. 2020

Lupus

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“…In clinical laboratories, the detection of larvae in stool samples is performed as a definitive diagnostic test. However, due to an irregular and small larval load in the faeces in the majority of patients with chronic infection, repeated stool examinations associated with different parasitological methods are necessary to establish an accurate diagnosis of Strongyloides infection (Dreyer et al ., 1996; Uparanukraw et al ., 1999; de Souza et al ., 2016). The parasitological methods that have been used include direct faecal smear, Baermann–Moraes method, spontaneous sedimentation, TF-Test®, formalin–ether concentration, filter-paper culture and agar plate culture (APC) (Arakaki et al ., 1990; Kobayashi et al ., 1996; Ericsson et al ., 2001).…”

Section: Introductionmentioning

confidence: 99%

Influence of parasite load on the diagnosis and occurrence of eosinophilia in alcoholic patients infected withStrongyloides stercoralis

et al. 2017

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Alcoholic patients are more susceptible to Strongyloides stercoralis infection. The chronic use of alcohol raises the levels of endogenous corticosteroids, which regulates the development of larvae and stimulates the differentiation of rhabditiform into infective filariform larvae, thus inducing internal autoinfection. Therefore, early diagnosis is important to prevent severe strongyloidiasis. The aim of this study was to evaluate the efficacy of parasitological methods, according to the parasite load and the number of stool samples, for diagnosis of S. stercoralis infection, as well the peripheral blood eosinophil count in alcoholic patients. A total of 330 patients were included in this study. The diagnosis was established using three parasitological methods: agar plate culture, Baermann-Moraes method and spontaneous sedimentation. Peripheral eosinophilia was considered when the level was >600 eosinophils/mm3. The agar plate culture (APC) had the highest sensitivity (97.3%). However, the analysis of multiple samples increased the sensitivity of all parasitological methods. The sensitivities of the methods were influenced by the parasite load. When the larval number was above 10, the sensitivity of APC was 100%, while in spontaneous sedimentation the sensitivity reached 100% when the larval number was above 50. In the present study, 15.4% of alcoholic patients infected with S. stercoralis (12/78) had increased peripheral blood eosinophil count (above 600 eosinophils/mm3). For an efficient parasitological diagnosis of S. stercoralis infection in alcoholic patients, repeated examination by two parasitological methods must be recommended, including agar plate culture due to its higher sensitivity. Moreover, S. stercoralis infection was associated with eosinophilia, mostly in patients excreting up to 10 larvae/g faeces.

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“…The frequency of specific anti-S. stercoralis antibodies was 20.8%, which was much higher than the prevalence of larvae in feces. Souza, et al 41 demonstrated a seroprevalence of 16.0% of S. stercoralis antibodies contrasting with 1.3% of positive parasitological diagnosis in individuals with lupus erythematosus. Conversely, frequencies of specific antibodies and S. stercoralis larvae in feces were very similar in alcoholic individuals, 22.0% and 23.5%, respectively, with a high agreement between the diagnostic methods 42 .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Strongyloides stercoralis infection in patients with HTLV-1

et al. 2022

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Introduction: Individuals infected with the human T-lymphotropic virus type 1 (HTLV-1) may present severe and disseminated forms of Strongyloides stercoralis infection with low therapeutic response.Objective: To investigate the S. stercoralis infection and the seroprevalence of IgG anti-S. stercoralis antibodies in individuals infected with HTLV-1 attending the Reference Center for HTLV-1 (CHTLV) in Salvador, Bahia, Brazil.Materials and methods: We conducted a cross-sectional study in 178 HTLV-1-infected individuals treated at the HTLV specialized center between January, 2014, and December, 2018. The parasitological diagnosis of S. stercoralis was performed using the Hoffman, Pons and Janer, agar plate culture, and Baermann-Morais methods. The IgG anti-S. stercoralis detection was performed using an in house enzyme-linked immunosorbent assay (ELISA). The HTLV-1 infection was diagnosed using a commercial ELISA and confirmed by Western blot.Results: The frequency of S. stercoralis infection was 3.4% (6/178). Individuals infected with S. stercoralis from rural areas (50.0%; 3/6) also showed S. stercoralis hyperinfection (>3,000 larvae/gram of feces). The frequency of circulating anti-S. stercoralis IgG antibodies was 20.8% (37/178).Conclusions: HTLV-1-infected people living in precarious sanitary conditions are more prone to develop severe forms of S. stercoralis infection. Considering the high susceptibility and unfavorable outcome of the infection in these individuals, the serological diagnosis for S. stercoralis should be considered when providing treatment.

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Strongyloides stercoralis infection in patients with systemic lupus erythematosus: diagnosis and prevention of severe strongyloidiasis

Cited by 10 publications

References 31 publications

Prevalence and risk factors of strongyloidiasis in patients with systemic lupus erythematosus in Southern Thailand

Prevalence and risk factors of strongyloidiasis in patients with systemic lupus erythematosus in Southern Thailand

Influence of parasite load on the diagnosis and occurrence of eosinophilia in alcoholic patients infected withStrongyloides stercoralis

Evaluation of Strongyloides stercoralis infection in patients with HTLV-1

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