Outward migration of Gnathostoma spinigerum in interferon alpha treated hepatitis C patient.
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.
Sangchan
Apichat
A
Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
Sawanyawisuth
Kittisak
K
Intapan
Pewpan M
PM
Mahakkanukrauh
Ajanee
A
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
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C417083:peginterferon alfa-2b