Flare-up of ulcerative colitis after systemic corticosteroids: A strong case for Strongyloides

作     者：Shomron Ben-Horin Iris Barshack Yehuda Chowers Meir Mouallem 

作者机构：Department of Gastroenterology Sheba Medical Center and Sackler School of Medicine Tel-Aviv University Pathology Institute Sheba Medical Center and Sackler School of Medicine Tel-Aviv University Department of Medicine E Sheba Medical Center and Sackler School of Medicine Tel-Aviv University 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2008年第14卷第27期

页      面：4413-4415页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Ulcerative colitis Infection Parasites Eosinophilia Strongyloides 

摘      要：Super-imposed infection with intestinal organisms can mimic a flare-up of underlying disease in patients with inflammatory bowel disease (IBD). We report a case of patient with long standing ulcerative colitis (UC), who presented with abdominal pain, diarrhea and low- grade fever after receiving systemic corticosteroids for an unrelated disorder. Despite a negative stool examination, a peripheral eosinophilia reappeared upon tapering down of a corticosteroid dose. Subsequently, duodenal biopsies showed evidence for Strongyloides, presumably acquired 20 years ago when the patient was residing in Brazil. The patient fully recovered following anti-helmintic therapy. This case underscores the importance of considering Strongyloides in the work-up of flaring-up IBD patients, even if a history of residing or traveling to endemic areas is in the distant past.