RESUMO
A case of Strongyloides stercoralis hyperinfection in a patient with dermatomyositis and diabetes mellitus is herein reported. The case was a 60-year-old female admitted due to watery diarrhea and unconsciousness. She had a 10-year history of chronic immunosuppressive therapy including methotrexate and prednisolone for dermatomyositis. Stool parasitological examination revealed numerous rhabditiform larvae of threadworm "S. stercoralis." Larva in stool sample was characterized by sequencing of mitochondrial DNA. After treatment with ivermectin, the patient recovered without evidence of S. stercoralis in follow-up stool samples. In endemic areas, stool examination for detection of S. stercoralis should be performed on a regular basis for all patients receiving immunosuppressive therapy, as early detection and treatment are necessary to minimize complications of severe strongyloidiasis.
Assuntos
Dermatomiosite/parasitologia , Diabetes Mellitus/parasitologia , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/diagnóstico , Animais , Anti-Inflamatórios/uso terapêutico , Dermatomiosite/fisiopatologia , Diabetes Mellitus/imunologia , Diabetes Mellitus/fisiopatologia , Fezes/parasitologia , Feminino , Humanos , Hospedeiro Imunocomprometido , Larva/genética , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Prednisolona/uso terapêutico , Strongyloides stercoralis/genética , Estrongiloidíase/parasitologia , Inconsciência/parasitologia , Inconsciência/fisiopatologiaAssuntos
Gravidez , Adulto , Humanos , Feminino , Imunoglobulina A/isolamento & purificação , Polimiosite/imunologia , Toxoplasmose/imunologia , Dermatomiosite/diagnóstico , Dermatomiosite/imunologia , Dermatomiosite/parasitologia , Polimiosite/diagnóstico , Polimiosite/parasitologia , Toxoplasmose/complicações , Toxoplasmose/diagnósticoAssuntos
Gravidez , Adulto , Humanos , Feminino , Imunoglobulina A/isolamento & purificação , Toxoplasmose/imunologia , Polimiosite/imunologia , Toxoplasmose/diagnóstico , Toxoplasmose/complicações , Polimiosite/diagnóstico , Polimiosite/parasitologia , Dermatomiosite/diagnóstico , Dermatomiosite/imunologia , Dermatomiosite/parasitologiaAssuntos
Dermatomiosite/parasitologia , Leishmaniose Visceral/complicações , Gluconato de Antimônio e Sódio/uso terapêutico , Antiprotozoários/uso terapêutico , Criança , Dermatomiosite/tratamento farmacológico , Febre/etiologia , Humanos , Leishmaniose Visceral/tratamento farmacológico , Leishmaniose Visceral/parasitologia , Masculino , Dor/etiologiaRESUMO
We report a 59-year-old woman with severe dermatomyositis in association with high serum toxoplasma antibody titres who was successfully treated with pyrimethamine and sulphadiazine. This case supports an aetiological role for toxoplasmosis in the pathogenesis of some cases of dermatomyositis.
Assuntos
Dermatomiosite/parasitologia , Toxoplasmose , Dermatomiosite/tratamento farmacológico , Dermatomiosite/patologia , Quimioterapia Combinada , Feminino , Fundo de Olho , Mãos/patologia , Humanos , Pessoa de Meia-Idade , Pirimetamina/uso terapêutico , Pele/patologia , Sulfadiazina/uso terapêutico , Toxoplasmose/tratamento farmacológico , Toxoplasmose/patologiaRESUMO
In a patient with childhood dermatomyositis, high toxoplasma antibodies were found at the time of diagnosis. A direct immunofluorescence technique demonstrated active toxoplasmosis in the muscle biopsy. The response to treatment and follow-up in this patient suggest that toxoplasmosis could have caused the dermatomyositis.
