title: Outward migration of Gnathostoma spinigerum in interferon alpha treated hepatitis C patient.
abstract: After the first dose injection of pegylated interferon alpha-2b (Peg-IFN alpha-2b) to a HCV infected Thai woman, she developed cyclic painful swelling nodules on right upper quadrant of abdomen and right anterior lower chest wall. The nodules subsided spontaneously within 1-2 days but were recurrent after every Peg-IFN alpha-2b injection. She also experienced acute urticaria. After nine months of therapy, an immature male of G. spinigerum migrated out from the skin nodule shortly after a Peg-IFN alpha-2b injection as scheduled. The worm showed a head-bulb bearing 8 transverse rows of spines which indicated immature stage. It had well defined four pairs of caudal papillae on posterior body part which were used to identify male gender. Painful migratory swelling and urticaria disappeared after the parasite was removed. She was continually treated and had sustained both virological and biochemical responses to HCV treatment. This case demonstrates that the outward migration of G. spinigerum may be stimulated by the injection of Peg-IFN alpha-2b.
authors.affiliation: Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
authors.forename: Apichat
authors.initials: A
authors.lastname: Sangchan
authors.forename: Kittisak
authors.initials: K
authors.lastname: Sawanyawisuth
authors.forename: Pewpan M
authors.initials: PM
authors.lastname: Intapan
authors.forename: Ajanee
authors.initials: A
authors.lastname: Mahakkanukrauh
mesh_terms: D000328:Adult; D000818:Animals; D000998:Antiviral Agents / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use*; D005260:Female; D006039:Gnathostoma / Q000187:drug effects / Q000502:physiology*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use*; D008297:Male; D009068:Movement / Q000187:drug effects / Q000502:physiology; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D012876:Skin Diseases, Parasitic / Q000150:complications* / Q000469:parasitology; D017205:Spirurida Infections / Q000150:complications* / Q000469:parasitology; D016896:Treatment Outcome; D014581:Urticaria / Q000209:etiology
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C417083:peginterferon alfa-2b