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Carullo N, Divenuto F, Marascio N, Adams NJ, Giancotti A, Comi N, Faga T, Bolignano D, Coppolino G, Serapide F, Costa C, Torti C, Matera G, Quirino A, Andreucci M. A Rare Complication of Ascariasis: A Case of Acute Interstitial Nephritis. Diagnostics (Basel) 2023; 13:2054. [PMID: 37370949 DOI: 10.3390/diagnostics13122054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/08/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
Acute interstitial nephritis (AIN) due to helminths is a rare cause of acute kidney injury (AKI). Helminthiases often progresses insidiously, making diagnosis difficult. This was the case of a 72-year-old man, who presented with renal failure, itching and diarrhoea. Urinalysis revealed leukocyturia, microhaematuria and mild proteinuria. A full blood count revealed leucocytosis with eosinophilia. A stool parasitological examination revealed fertilised eggs of Ascaris lumbricoides. Tubulointerstitial nephropathy secondary to A. lumbricoides infection was suspected. A percutaneous renal biopsy was not performed since the patient refused the anti-platelet therapy discontinuation. Mebendazole, albendazole and prednisone therapy was administered. After worm eradiation and discharge, recovery from the parasitosis, absence of pruritus and eosinophilia, and progressive improvement of renal function were observed, strongly suggesting a causal relationship between Ascaris infection and AIN. Parasite infection should be considered in the differential diagnosis of unexplained renal failure because early diagnosis and treatment are necessary to avoid irreversible complications.
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Affiliation(s)
- Nazareno Carullo
- Nephrology and Dialysis Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Francesca Divenuto
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Nadia Marascio
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Neill James Adams
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Aida Giancotti
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Nicolino Comi
- Nephrology and Dialysis Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Teresa Faga
- Nephrology and Dialysis Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Davide Bolignano
- Nephrology and Dialysis Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Giuseppe Coppolino
- Nephrology and Dialysis Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Francesca Serapide
- Infectious and Tropical Disease Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Chiara Costa
- Infectious and Tropical Disease Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Carlo Torti
- Infectious and Tropical Disease Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Giovanni Matera
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Angela Quirino
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Michele Andreucci
- Nephrology and Dialysis Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
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