title: Endoscopic and histopathological study on the duodenum of Strongyloides stercoralis hyperinfection.
abstract: OBJECTIVE
  To investigate endoscopic and histopathological findings in the duodenum of patients with Strongyloides stercoralis (S. stercoralis) hyperinfection.
  
  
  METHODS
  Over a period of 23 years (1984-2006), we investigated 25 patients with S. stercoralis hyperinfection who had had an esophagogastroduodenoscopy before undergoing treatment for strongyloidiasis. The clinical and endoscopic findings were analyzed retrospectively.
  
  
  RESULTS
  Twenty-four (96%) of the patients investigated were under immunocompromised condition which was mainly due to a human T lymphotropic virus type 1 (HTLV-1) infection. The abnormal endoscopic findings, mainly edematous mucosa, white villi and erythematous mucosa, were observed in 23 (92%) patients. The degree of duodenitis including villous atrophy/destruction and inflammatory cell infiltration corresponded to the severity of the endoscopic findings. The histopathologic yield for identifying larvae was 71.4% by duodenal biopsy. The endoscopic findings of duodenitis were more severe in patients whose biopsies were positive for larvae than those whose biopsies were negative (Endoscopic severity score: 4.86 +/- 2.47 vs 2.71 +/- 1.38, P < 0.05).
  
  
  CONCLUSIONS
  Our study clearly demonstrates that, in addition to stool analysis, endoscopic observation and biopsies are very important. We also emphasize that S. stercoralis and HTLV-1 infections should be ruled out before immunosuppressive therapy is administered in endemic regions.
authors: Department of Endoscopy, Ryukyu University Hospital, Okinawa 903-0215, Japan.
authors: Kazuto
authors: K
authors: Kishimoto
authors: Akira
authors: A
authors: Hokama
authors: Tetsuo
authors: T
authors: Hirata
authors: Yasushix
authors: Y
authors: Ihama
authors: Manabu
authors: M
authors: Nakamoto
authors: Nagisa
authors: N
authors: Kinjo
authors: Fukunori
authors: F
authors: Kinjo
authors: Jiro
authors: J
authors: Fujita
mesh_terms: D000368:Aged; D000818:Animals; D001706:Biopsy; D004382:Duodenitis / Q000469:parasitology / Q000473:pathology*; D004386:Duodenum / Q000469:parasitology / Q000473:pathology*; D016145:Endoscopy, Digestive System; D005243:Feces / Q000469:parasitology; D005260:Female; D015490:HTLV-I Infections / Q000150:complications; D006801:Humans; D007413:Intestinal Mucosa / Q000469:parasitology / Q000473:pathology; D007564:Japan; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013183:Sputum / Q000469:parasitology; D017171:Strongyloides stercoralis / Q000302:isolation & purification*; D013322:Strongyloidiasis / Q000150:complications / Q000469:parasitology / Q000473:pathology*