ABSTRACT
Hepatic fascioliasis is a trematodiasis acquired by the use of contamined vegetables or water with metacercariae. The disease has two periods, the invasive or hepatic phase and the biliary phase. The diagnosis is done demonstrating the parasite or its ova or with indirect methods detecting antibodies. Treatment includes: benzimidazoles, prazicuantel, nitazoxanide, bithionol and triclabendazole. We report a 3-year-old boy who was admitted to the hospital with a two months history of fever, malaise, pallor and weight loss. The examination revealed pallor, fever and hepatomegaly. The laboratory evaluation showed elevation of CRP (C-reactive protein), liver enzymes, circulant immnune complex and IgG, eosinophilia, positive antinuclear antibodies, p -ANCA (perinuclear-antineutrophil cytoplasm antibodies) and anti-smooth muscle antibodies. The findings of the abdominal arteriography suggested Polyarteritis Nodosa. The Elisa to hidatidosis and fasciola were positive, however, these results were considered immunologic cross-reaction and the diagnosis of Polyarteritis Nodosa was supported. Immunosupresor and corticosteroid therapy was begun. Two months later he persisted with fever, eosinophilia and high levels of hepatic enzymes and IgE, and the stool samples revealed abundant eggs of fasciola hepatica. The patient was successfully treated with triclabendozale. The diagnosis and treatment of fascioliasis is complicated by the fact that many physicians at no endemic areas rarely found this disease and as in this case many serological findings can be similar with those founded in systemic vasculitis