In Vivo Endoscopic Imaging of Ancylostomiasis-Induced Gastrointestinal Bleeding: Clinical and Biological Profiles

Barakat, Maha T; Ibrahim, Naglaa; Nasr, Ahmed Aboul

doi:10.4269/ajtmh.2012.12-0018

Cited by 14 publications

(15 citation statements)

References 20 publications

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“…The observed positive association between CRP and presence of hookworm in pregnancy may be explained by different degrees of tissue damage caused by the adult worms. In contrast to the non-invasive manner by which adult Ascaris worms feed [ 78 ], hookworm adults invade the mucosa and submucosa of the small intestine where the release of hydrolases and mechanical injury associated with feeding results in considerable tissue damage [ 79 ]. An additional justification for the different response of CRP between hookworm and Ascaris in pregnancy is explained by the capacity of the adult hookworm Necator americanus to produce proteases that specifically cleave the eosinophil chemoattractant eotaxin [ 80 ] whereas Ascaris induces higher transcription levels of eotaxin at least in pigs [ 81 ].…”

Section: Discussionmentioning

confidence: 99%

C-reactive protein is differentially modulated by co-existing infections, vitamin deficiencies and maternal factors in pregnant and lactating indigenous Panamanian women

et al. 2017

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BackgroundThe usefulness of C-reactive protein (CRP) as a non-specific marker of inflammation during pregnancy and lactation is unclear in impoverished populations where co-existing infections and vitamin deficiencies are common.MethodsThis cross-sectional study in Panama recruited 120 pregnant and 99 lactating Ngäbe-Buglé women from 14 communities in rural Panama. Obstetric history, indoor wood smoke exposure, fieldwork, BMI, vitamins A, B12, D, and folic acid, and inflammation markers (CRP, neutrophil/lymphocyte ratio (NLR), plateletcrit and cytokines) were measured. Multiple regressions explored both associations of CRP with other inflammatory markers and associations of CRP and elevated CRP based on trimester-specific cut-offs with maternal factors, infections and vitamin deficiencies.ResultsCRP was higher in pregnancy (51.4 ± 4.7 nmol/L) than lactation (27.8 ± 3.5 nmol/L) and was elevated above trimester specific cut-offs in 21% of pregnant and 30% of lactating women. Vitamin deficiencies were common (vitamin A 29.6%; vitamin D 68.5%; vitamin B12 68%; folic acid 25.5%) and over 50% of women had two or more concurrent deficiencies as well as multiple infections. Multiple regression models highlighted differences in variables associated with CRP between pregnancy and lactation. In pregnancy, CRP was positively associated with greater indoor wood smoke exposure, caries and hookworm and negatively associated with Ascaris and vaginal Lactobacillus and Bacteroides/Gardnerella scores. Consistent with this, greater wood smoke exposure, caries as well as higher diplococcal infection score increased the odds of trimester-elevated CRP concentrations whereas longer gestational age lowered the likelihood of a trimester-elevated CRP. During lactation, folic acid deficiency was associated with higher CRP whereas parity, number of eosinophils and Mobiluncus score were associated with lower CRP. Also, a higher BMI and Trichomonas vaginalis score increased the likelihood of an elevated CRP whereas higher parity and number of eosinophils were associated with lower likelihood of an elevated CRP.ConclusionsInfections both raise and lower CRP concentrations in pregnant and lactating mothers. Only folic acid deficiency during lactation was associated with higher CRP concentrations. Caution is required when interpreting CRP concentrations in pregnant and lactating women who have co-existing nutrient deficiencies and multiple infections.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-017-0307-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

C-reactive protein is differentially modulated by co-existing infections, vitamin deficiencies and maternal factors in pregnant and lactating indigenous Panamanian women

et al. 2017

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“…People of the areas mentioned above were easy to be infected by hookworms, especially among young adults [ 5 ]. Ancylostomiasis can be confirmed by endoscopy [ 6 ], and this disease could cause gastrointestinal bleeding and iron-deficiency anemia [ 7 , 8 ]. Clinically, albendazole is an effective anthelmintic [ 9 ].…”

Section: Dicussionmentioning

confidence: 99%

Hookworm Anemia in a Peritoneal Dialysis Patient in China

Wu¹,

Xu²,

Xia³

et al. 2016

Korean J Parasitol

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Hookworm infections as well as other intestinal nematodiases are endemic in China. In this case, a 70-year-old male showed symptoms of chest tightness, shortness of breath, and both lower extremities edema. The diagnostic result was chronic renal insufficiency, chronic kidney disease (5th stage), and renal anemia at first. Then, he received treatment with traditional drugs. However, this treatment did not help to alleviate the symptoms of the patient significantly. The results of gastroendoscopy showed hookworms in the duodenum, also confirmed by pathology examination. Anemia was markedly ameliorated after eliminating the parasites. The results mentioned above suggested that ancylostomiasis was the leading causes of anemia in this patient, and the etiology of anemia in uremic patients should be systematically considered. Especially when anemia could not be cured by regular treatments, rare diseases should be investigated.

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“…in five cases where the bleeding responded rapidly to antihelminthic treatment. [ 12 ] Similarly, Kuo et al . have reported the successful eradication of hookworm and termination of active bleeding following mebendazole therapy.…”

Section: Discussionmentioning

confidence: 99%

Association of three H - Hookworm, hemosuccus pancreaticus, and hypertension (portal) in a patient with melena

Kale

Sahu

Verma

et al. 2017

J Global Infect Dis

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Hookworm infestations, endemic in India, are a common cause of iron deficiency anemia. Hemosuccus pancreaticus, a rare clinical condition, is due to passage of blood into the pancreatic duct possibly through a route between an aneurysm of an artery close to the pancreas and/or pancreatic duct, leading to gastrointestinal (GI) bleeding. Portal hypertensive upper GI bleed is also known since long. We report a case of a 38-year-old male with a history of alcoholism who was being investigated for GI bleeding who had concomitant hookworm infestation, hemosuccus pancreaticus as well as portal hypertension. To the best of our knowledge, this is the first report of common occurrence of hemosuccus pancreaticus and portal hypertension with hookworm infection. This case signifies the importance of infectious causes of GI bleeding to be considered even in cases where anatomic malformations or pathophysiological alterations are predominant.

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In Vivo Endoscopic Imaging of Ancylostomiasis-Induced Gastrointestinal Bleeding: Clinical and Biological Profiles

Cited by 14 publications

References 20 publications

C-reactive protein is differentially modulated by co-existing infections, vitamin deficiencies and maternal factors in pregnant and lactating indigenous Panamanian women

C-reactive protein is differentially modulated by co-existing infections, vitamin deficiencies and maternal factors in pregnant and lactating indigenous Panamanian women

Hookworm Anemia in a Peritoneal Dialysis Patient in China

Association of three H - Hookworm, hemosuccus pancreaticus, and hypertension (portal) in a patient with melena

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