Malignant Lymphoma Initiated with Malabsorption Syndrome Due to Isospora belli Infection and Lymphocytosis

Clinical Significance of Enteric Protozoa in the Immunosuppressed Human Population

“…In severely IS patients, severe chronic diarrhea is often reported and has been associated with fulminant diarrhea leading to a wasting syndrome and sometimes death in AIDS patients (46). Diarrhea associated with I. belli infections has also been reported in patients with other immunosuppressive diseases, such as lymphoblastic leukemia (148,283), adult T-cell leukemia (115, 159), Hodgkin's disease (225), non-Hodgkin's lymphoma (234), lymphoproliferative disorders (159,214), and renal transplant recipients (169), and in a liver transplant patient with chronic diarrhea (15). Patients with malabsorption syndrome, particularly malnourished children, are also at increased risk of chronic isosporiasis (21,168).…”

Isospora belli infection in a patient with non-Hodgkin's lymphoma

“…Acute diarrhea due to I. belli mainly affects patients from tropical countries, especially Africa and the Middle East, where I. belli is endemic [2]. Cases have been reported in immunocompromised patients in Argentina, Haiti and Trinidad [1,3,4], India [5], Taiwan [6], and Japan [7–9]. Our patient came from Mali, but he had been living in France for 8 years.…”

“…I. belli infection is frequent and common in patients with AIDS [1,3], with an incidence ranging from approximately 0.2% to 20% in tropical areas. It has been reported rarely in other immunosuppressive diseases, such as lymphoblastic leukemia [2,5], adult T‐cell leukemia [4,7,8] and Hodgkin's disease associated with HTLV‐1 seropositivity, either prior to or after chemotherapy [6,9]. Several cases of I. belli infection associated with lymphoproliferative disorders have been reported in Japan [7–9].…”

“…It has been reported rarely in other immunosuppressive diseases, such as lymphoblastic leukemia [2,5], adult T‐cell leukemia [4,7,8] and Hodgkin's disease associated with HTLV‐1 seropositivity, either prior to or after chemotherapy [6,9]. Several cases of I. belli infection associated with lymphoproliferative disorders have been reported in Japan [7–9]. Our patient had negative results for antibodies to HTLV‐1, HIV‐1, and HIV‐2.…”

“…Our patient had negative results for antibodies to HTLV‐1, HIV‐1, and HIV‐2. The cellular immunodeficiency due to NHL may have increased the patient's susceptibility to this parasitic infection [9], as in another case of I. belli ‐related diarrhea reported in a Japanese patient with NHL [9]. The true incidence of I. belli ‐related diarrhea in NHL patients may be underestimated in tropical countries.…”