IRON DEFICIENCY ANEMIA AND ANCYLOSTOMA DUODENALE Onofre Alarc

1
IRON DEFICIENCY ANEMIA AND ANCYLOSTOMA
DUODENALE Onofre Alarcón, Antonio Sánchez del
Río, Salvador Baudet, Servicio de Digestivo.
Tenerife. Canary Islands. Spain
INTERNATIONAL COURSE ON CAPSULE ENDOSCOPY ICCE
2005 Miami Florida USA

• CLINICAL CASE
• A 58 year old man with iron deficiency anemia was
  referred to our Unit for a wireless capsule
  endoscopy
• Study. He had no diarrhea, abdominal pain, weight
  loss or rectal bleeding.
• A hemoccult test was positive, so he had been
  previously studied with a full colonosocpy, upper
  endoscopy
• and small bowel series with negative resultaste
  patient had no family history of cancer or
  inflammatory bowel
• Disease.
• He had not past history of peptic disease, NSAIDs
  intake or alcohol consuption.
• Celiac disease was also ruled out and a
  hematologic consultation show not any other
  specific consultation.
• A wireless capsule endoscopy study was done,
  showing multiple round small ulcers, some fresh
  and some
• covered with black fibrina, along the distal
  jejunum and ileum.
• At ileum several white, small filliform figures
  attached to the bowel wall were found. They
  showed a slightly
• dilatated reddish portion in the anchorage point.
  
• A suspicion diagnosis of hookworm disease was
  done, confirmed with a direct fecal examination
• which showed oval eggs .
• Treatment with iron repletion and antihelmintic
  therapy with albendazole was started, and the
  anemia
• resolves
• DISCUSSION

Fresh ulcer
Fresh ulcer
Ulcer with clot
A duodenale
A duodenale
A duodenale and ulcer

• CONCLUSIONS
• Hookworm infection represents an important public
  health problem in developing countries.
• The inmigration process to Western countries has
  increased the recognition of this disease as a
  cause of anemia.
• As wireless capsule endoscopy has become the
  procedure of choice for small bowel imaging in
  the evaluation of iron deficiency anemia
  physicians performing this test must be
  familiarized with the capsule findings of
  hookworm infection.

BIBLIOGRAPHY Pearson RD Parasitic diseases
helminths Chapter 109, 2442-2459 In Tadataka
Yamada Textbook of Gastroenterology volume 2
Third edition Lippincott Williams Wilkins
Philadelphia 1999 Roca C, Balanzo X, Sauca G,
Fernandez-Roure JL, Boixeda R, Ballester M
Imported hookworm infection in African immigrants
in Spain A study of 285 patients Med Clin (Barc)
2003 Jun 28 121(4)139-41