Open AccessFlare-up of ulcerative colitis after systemic corticosteroids: A strong case for Strongyloides
Author(s) -
Shomron BenHorin,
Iris Barshack,
Yehuda Chowers,
Meir Mouallem
Publication year - 2008
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.14.4413
Subject(s) - strongyloides stercoralis , medicine , ulcerative colitis , strongyloides , eosinophilia , inflammatory bowel disease , diarrhea , abdominal pain , gastroenterology , strongyloidiasis , immunology , disease , dermatology , helminths
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.