We describe a case of systemic lupus erythematosus complicated by strongyloidiasis. The parasitic infection appeared with diarrhoea, weight loss and peripheral eosinophilia in association with recurrence of polyarthritis, probably due to a flare of systemic lupus erythematosus. The literature about the coexistence of systemic lupus erythematosus and strongyloidiasis has been reviewed.
Boscolo M., Gobbo M., Mantovani W., et al. Evaluation of an indirect immunofluorescence assay for strongyloidiasis as a tool for diagnosis and follow-up. Clin Vaccine Immunol2007; 14: 129-133.
2.
Rivasi F., Pampiglione S., Boldorini R., Cardinale L.Histopathology of gastric and duodenal Strongyloides stercoralis locations in fifteen immunocompromised subjects. Arch Pathol Lab Med2006; 130: 1792-1798.
3.
Pirisi M., Salvador E., Bisoffi Z., et al. Unsuspected strongyloidiasis in hospitalized elderly patients with and without eosinophilia. Clin Microbiol Infect2006; 12: 787-792.
4.
Carvalho EM, Da Fonseca Porto A.Epidemiological and clinical interaction between HTLV-1 and Strongyloides stercoralis. Parasite Immunol2004; 26: 487-497.
5.
Segarra-Newnham M.Manifestations, diagnosis, and treatment of Strongyloides stercoralis infection. Ann Pharmacother2007; 41: 1992-2001.
6.
Keiser PB, Nutman TBStrongyloides stercoralis in the immunocompromised population. Clin Microbiol Rev2004; 17: 208-217.
7.
Debussche X. , Toublanc M., Camillieri JP, Assan R.Overwhelming strongyloidiasis in a diabetic patient following ACTH treatment and keto-acidosis. Diabetes Metab1988; 14: 294-298.
8.
Rivera E., Maldonado N., Vélez-García E., Grillo AJ, Malaret G.Hyperinfection syndrome with Strongyloides stercoralis. Ann Intern Med1970; 72: 199-204.
9.
Lam CS, Tong MK, Chan KM, Siu YPDisseminated strongyloidiasis: a retrospective study of clinical course and outcome. Eur J Clin Microbiol Infect Dis2006 ; 25: 14-18.
10.
Yoshida H., Endo H., Tanaka S., Ishikawa A., Kondo H., Nakamura T.Recurrent paralytic ileus associated with strongyloidiasis in a patient with systemic lupus erythematosus. Mod Rheumatol2006; 16: 44-47.
11.
Barrett-Conner E.Parasitic pulmonary disease. Am Rev Respir Dis1982; 126: 558-563.
12.
Mora CS, Segami MI, Hidalgo JAStrongyloides stercoralis hyperinfection in systemic lupus erythematosus and the antiphospholipid syndrome. Semin Arthritis Rheum2006; 36: 135-143.
13.
Arsic-Arsenijevic V., Dzamic A., Dzamic Z., Milobratovic D., Tomic D.Fatal Strongyloides stercoralis infection in a young woman with lupus glomerulonephritis. J Nephrol2005; 18: 787-790.
14.
Potter A., Stephens D., De Keulenaer B.Strongyloides hyper-infection: a case for awareness. Ann Trop Med Parasitol2003; 97: 855-860.
15.
Fardet L., Genereau T., Poirot JL, Guidet B., Kettaneh A., Cabane J.Severe strongyloidiasis in corticosteroid-treated patients: case series and literature review. J Infect2007; 54: 18-27.
16.
Hunter CJ, Petrosyan M., Asch M.Dissemination of Strongyloides stercoralis in a patient with systemic lupus erythematosus after initiation of albendazole: a case report. J Med Case Reports2008; 2: 156.
17.
Hayden GM, Atlas SAStrongyloidiasis masquerading as inflammatory bowel disease in a patient with lupus erythematosus: a case report. Conn Med1995; 59: 649-650.
18.
Setoyama M. , Fukumaru S., Takasaki T., Yoshida H., Kanzaki T.SLE with death from acute massive pulmonary hemorrhage caused by disseminated strongyloidiasis. Scand J Rheumatol1997; 26: 389-391.
19.
Lemos LB, Qu Z., Laucirica R., Fred HLHyperinfection syndrome in strongyloidiasis: report of two cases. Ann Diagn Pathol2003; 7: 87-94.
20.
Reiman S., Fisher R., Dodds C., Trinh C., Laucirica R., Whigham CJMesenteric arteriographic findings in a patient with strongyloides stercoralis hyperinfection. J Vasc Interv Radiol2002; 13: 635-638.
21.
Finkielman JD, Grinberg AR, Paz LA, et al. Case report: reactive hemophagocytic syndrome associated with disseminated strongyloidiasis. Am J Med Sci1996; 312: 37-39.
22.
Livneh A., Coman EA, Cho SH, Lipstein-Kresch E.Strongyloides stercoralis hyperinfection mimicking systemic lupus erythematosus flare. Arthritis Rheum1988; 31: 930-931.
Berger R., Kraman S., Paciotti M.Pulmonary strongyloidiasis complicating therapy with corticosteroids. Report of a case with secondary bacterial infections. Am J Trop Med Hyg1980; 29: 31-34.
25.
Webster E., Ballinger WE Jr, Panush RSA case of a patient with deteriorating multisystem disease. Ann Allergy1984; 52: 399-400. (423-427).
26.
Schad GACyclosporine may eliminate the threat of overwhelming strongyloidiasis in immunosuppressed patients. J Infect Dis1986 ; 153: 178.
27.
Doria A., Canova M., Tonon M., et al. Infections as triggers and complications of systemic lupus erythematosus . Autoimmun Rev2008; 8: 24-28.
28.
Rezza G., Nicoletti L., Angelini R., et al. Infection with Chikungunya virus in Italy: an outbreak in a temperate region. Lancet2007; 370: 1840-1846.
