title: [Strongyloidiasis in nephrologic patients].
abstract: Strongyloides stercoralis is a nematode causing strongyloidiasis, more frequent in immigrants and in travelers coming from tropical and subtropical areas. Infection is usually asymptomatic, frequently associated with eosinophilia. Immunocompromised patients are at high risk of developing hyperinfection syndrome (HI) or dissemination (SD), life threatening complications. Diagnosis of strongyloidiasis is firstly based on larvae isolation in stool samples; specific therapy involves the use of ivermectin as first choice and albendazole as second choice. We describe two cases of strongyloidiasis. The first one is a disseminated strongyloidiasis occurred in an Ecuadorian male on corticosteroid therapy for nephrotic syndrome due to focal segmental glomerulosclerosis, successfully treated with ivermectin; the second one involves another Ecuadorian male affected by acute kidney failure and nephrotic syndrome in IgA nephropathy with a diagnosis of chronic strongyloidiasis performed before starting the immunosuppressive treatment. The timing of treatment with ivermectin has allowed the complete eradication of the parasite before starting steroid and mycophenolate mofetil therapy, preventing the occurrence of a disseminated infection. Epidemiological data show us how strongyloidiasis is rising at our latitude because of increased number of migrants and travelers coming from endemic areas. So we must always exclude asymptomatic strongyloidiasis before prescribing a steroid or immunosuppressive therapy, in order to avoid developement of disseminated and often fatal disease.
authors.forename: Luciana
authors.initials: L
authors.lastname: Gravellone
authors.forename: Carmelo
authors.initials: C
authors.lastname: Battaglia
authors.forename: Fabiana
authors.initials: F
authors.lastname: Caligara
authors.forename: Ippolita
authors.initials: I
authors.lastname: D'Amato
authors.forename: Eligio
authors.initials: E
authors.lastname: Gandini
authors.forename: Angelo
authors.initials: A
authors.lastname: Lucatello
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Rizzo
authors.forename: Regina
authors.initials: R
authors.lastname: Torpia
authors.forename: Gioconda
authors.initials: G
authors.lastname: Brigante
authors.forename: Alessandro
authors.initials: A
authors.lastname: Castiglioni
mesh_terms: D000328:Adult; D000969:Antinematodal Agents / Q000627:therapeutic use; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use; D007674:Kidney Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D013322:Strongyloidiasis / Q000150:complications* / Q000188:drug therapy
chemical_list: D000969:Antinematodal Agents; D007559:Ivermectin