Article

Overt gastrointestinal bleeding because of hookworm infection

Department of Gastroenterology, Second Affiliated Hospital, ZheJiang University College of Medicine, Hangzhou 310009, Zhejiang Province, China.
Asian Pacific Journal of Tropical Medicine (Impact Factor: 0.93). 04/2012; 5(4):331-2. DOI: 10.1016/S1995-7645(12)60051-0
Source: PubMed
ABSTRACT
Hookworm infection is a relatively common cause of anemia in endemic areas. The most common hookworm species are Ancylostoma duodenale and Necator americanus. In this report we present a case of overt gastrointestinal bleeding because of hookworm infection. Capsule endoscopy revealed many hookworms in the lumen of proximal jejunum where active bleeding was seen. The patient was successfully treated with Albendazole.

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331
Asian Pacific Journal of Tropical Medicine (2012)331-332
Document heading
doi:
Overt gastrointestinal bleeding because of hookworm infection
Jia-Min Chen, Xin-Mei Zhang, Liang-Jing Wang, Yan Chen, Qin Du, Jian-Ting Cai
*
Department of Gastroenterology, Second Affiliated Hospital, ZheJiang University College of Medicine, Hangzhou 310009, Zhejiang Province, China
Contents lists available at ScienceDirect
Asian Pacific Journal of Tropical Medicine
journal homepage:www.elsevier.com/locate/apjtm
ARTICLE INFO ABSTRACT
Article history:
Received 16 December 2011
Received in revised form 15 January 2012
Accepted 15 March 2012
Available online 20 April 2012
Keywords:
Capsule endoscopy
Hookworm infection
Overt gastrointestinal bleeding
*Corresponding author: Jian-Ting Cai, MD&Ph.D, Department of Gastroenterology,
Second Affiliated Hospital, ZheJiang University College of Medicine, 88 Jiefang Road,
Hangzhou 310009, Zhejiang Province, China.
Tel: 86-0571-87783565
Fax: 86-0571-87022776
E-mail: jtcai6757@163.com
1. Introduction
Hookworm infection is widely distributed in Asia
and Africa but can also be found in other tropical and
subtropical zones. Most of patients with hookworm infection
are asymptomatic or have mild degrees of anemia, overt
gastrointestinal bleeding caused by hookworm is very rare.
We report a case of overt gastrointestinal bleeding caused
by hookworm, whose hookworm infection was diagnosed by
caps
ule endoscopy.
2. Case report
A
53-year-old male patient was admitted due to
intermittent tarry stool with fatigue and shortness of breath
for
1 week. On admission, his physical examination showed
pale conjunctiva. Laboratory data revealed hemoglobin
of
66 g/L (normal: 120-160 g/L), white blood cell count
of
5.3×10
9
/L (normal: 4-10×10
9
/L) and eosinophils
percentage of
5.1%(normal: 0%-10%) .The patient
'
s fecal
occult blood was positive, which suggested gastrointestinal
bleeding with anemia. Stool examination revealed no
parasite infection. Transfusions of red blood cells were given
to maintain his hemoglobin around
95 g/L. After admission,
the patient received esophagogastroduodenoscopy and
colonoscopy, but the location of bleeding was not identified.
Therefore, capsule endoscopy was arranged to identi
fy if
there were lesions in the small intestine that caused the
blood loss and it revealed many hookworms in the lumen of
proximal jejunum where active bleeding was seen (Figure
1, 2). The patient was then treated with albendazole and
oral iron supplementation. Both of his hemoglobin and
hematocrit were improved to normal range in a follow up
visit
2 months later.
Hookworm infection is a relatively common cause of anemia in endemic areas. The most common
hookworm species are Ancylostoma duodenale and Necator americanus. In this report we present
a case of overt gastrointestinal bleeding because of hookworm infection. Capsule endoscopy
revealed many hookworms in the lumen of proximal jejunum where active bleeding was seen.
The patient was successfully treated with Albendazole.
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    • "These findings are in agreement with previous reports published elsewhere (Degarege et al., 2014; Righetti et al., 2013). Indeed, hookworm infection and schistosomiasis cause chronic intestine inflammation with continued intestinal blood loss (Gyorkos et al., 2011; Larocque et al., 2005; Ngui et al., 2012; Righetti et al., 2013) and are thus drivers of anaemia (Chen et al., 2012; Ngui et al., 2012; Pasricha et al., 2008). Third, multiparasitism has previously been shown to be a potential cause for child anaemia and malnutrition. "
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