Diagnosis of a case with severe iron-deficiency anemia caused by hookworm infections
HU Haiyan1, CUI Qingrong1, YU Li2, LUO Saifei1, GE Junhua1, QIU Danhong2
1. Department of Laboratory Medicine, Tiantai Center for Disease Control and Prevention, Tiantai, Zhejiang 317200, China; 2. Tiantai County People's Hospital, Tiantai, Zhejiang 317200, China; 3. Taizhou Center for Disease Control and Prevention, Taizhou, Zhejiang 318000, China
Abstract：On April 25, 2021, a case with hookworm infections was identified during the surveillance of soil-borne nematodiasis by Tiantai Center for Disease Control and Prevention, Taizhou City, Zhejiang Province. The patients was admitted to a county people's hospital due to dizziness and limb weakness on July 24, 2020. Laboratory tests showed 2.5×1012/L red blood cell counts, 45 g/L hemoglobin, 3.4% eosinophil percentage, 4.7 μmol/L serum iron and <1 μg/L ferritin, and severe iron-deficiency anemia was initially diagnosed. Following treatment with blood transfusion and ion supplement, subsequent three routine blood tests indicated elevated eosinophil percentages. On April 25, 2021, hookworm eggs were detected in stool samples using Kate-Katz technique, and Necator americanus was identified with the test-tube filter-paper culture method. Severe iron-deficiency anemia caused by hookworm infections was diagnosed based on field epidemiological surveys and laboratory tests. The health education pertaining to parasitic disease control knowledge among residents and the diagnosis and treatment of parasitic diseases in medical institutions are recommended to be improved in rural areas to avoid misdiagnosis and missing diagnosis.
胡海燕, 崔清荣, 余力, 罗赛飞, 葛君华, 裘丹红. 一例钩虫感染重度缺铁性贫血病例诊断分析[J]. 预防医学, 2022, 34(11): 1178-1180,1186.
HU Haiyan, CUI Qingrong, YU Li, LUO Saifei, GE Junhua, QIU Danhong. Diagnosis of a case with severe iron-deficiency anemia caused by hookworm infections. Preventive Medicine, 2022, 34(11): 1178-1180,1186.
[1] 中华人民共和国国家卫生和计划生育委员会.肠道蠕虫检测改良加藤厚涂片法:WS/T 570—2017[S].2017. National Health and Family Planning Commission of the People's Republic of China.Detection of intestinal helminths-the Kato-Katz method:WS/T 570-2017[S].2017. [2] 王旗,汪天平.十二指肠钩虫和美洲钩虫鉴定方法研究进展[J].热带病与寄生虫学,2019,17(2):119-123. WANG Q,WANG T P.Research progress on identification methods of Ancylostoma duodenalis and Ancylostoma Americana[J].J Trop Dis Parasitol,2019,17(2):119-123. [3] 李雍龙,管晓虹.人体寄生虫学[M].7版.北京:人民卫生出版社,2012:168-173. LI Y L,GUAN X H.Human parasitology[M].7th ed.Beijing:People's Medical Publishing House,2012:168-173. [4] 白财福,杨亚明.人体钩虫病流行现况与治疗进展[J].中国病原生物学杂志,2020,15(7):865-869. BAI C F,YANG Y M.The prevalence of human hookworm disease and advances in its treatment[J].Chin J Pathog Biol,2020,15(7):865-869. [5] 汪小元. 钩虫病致重度贫血32例误诊原因分析[J].湖南医学,2002,19(2):76-77. WANG X Y.Causes of misdiagnosis of 32 cases with severe anemia caused by hookworm disease[J].Hunan Med J,2002,19(2):76-77. [6] 姚立农,阮卫,余可根,等.浙江省人体土源性线虫病调查及防治效果分析[J].疾病监测,2012,27(6):459-461. YAO L N,RUAN W,YU K G,et al.Survey of prevention and treatment of human intestinal parasitic diseases in Zhejiang[J].Dis Surveill,2012,27(6):459-461. [7] 龙婷婷,陈月梅,陶泽,等.自动粪便处理分析系统FA280临床应用分析[J].中国医疗设备,2022,37(4):132-135. LONG T T,CHEN Y M,TAO Z,et al.The clinical application analysis of automatic fecal analysis system FA280[J].China Med Devices,2022,37(4):132-135. [8] 袁菊,徐杰,张伟琴.钩虫病误诊1例[J].皮肤病与性病,2020,42(1):97-98. YUAN J,XU J,ZHANG W Q.Misdiagnosis of a case with hookworm disease[J].J Dermatol Venereol,2020,42(1):97-98. [9] 谭丹. 重症肺炎并钩虫病致上消化道大出血一例误诊辨析[J].临床误诊误治,2017,30(9):6-7. TAN D.Misdiagnosis of a case with massive hemorrhage of upper digestive tract caused by severe pneumonia and hookworm disease[J].Clin Misdiagn Misther,2017,30(9):6-7. [10] 冯敏亚,蒋丽娟,周围,等.1例钩虫病致重度贫血病例的诊疗经过与分析[J].临床检验杂志,2022,40(4):314-315. FENG M Y,JIANG L J,ZHOU W,et al.Diagnosis and treatment of a case with severe anemia caused by hookworm disease[J].Chin J Clinical Lab Sci,2022,40(4):314-315. [11] 陈玉华,王伟强.钩虫病致上消化道出血误诊1例[J].现代医药卫生,2018,34(18):2936-2938. CHEN Y H,WANG W Q.A misdiagnosed case of upper gastrointestinal hemorrhage caused by hookworm disease[J].J Mod Med Health,2018,34(18):2936-2938. [12] 温春虹,曾智聪,刘将,等.消化内镜诊治寄生虫感染614例分析[J].中国内镜杂志,2019,25(12):71-75. WEN C H,ZENG Z C,LIU J,et al.Analysis of 614 cases of parasite infection diagnosed and treated by gastrointestinal endoscope[J].China J Endosc,2019,25(12):71-75. [13] 葛昊平. 胃镜诊断钩虫病32例分析[J].现代预防医学,2007,34(18):3597. GE H P.Analysis of 32 cases with hookworm disease diagnosed by gastroscopy[J].Mod Prev Med,2007,34(18):3597. [14] 刘艳珍,李静,王国英.胃镜检查发现美洲钩虫病1例报道[J].中国病原生物学杂志,2021,16(6):743-744. LIU Y Z,LI J,WANG G Y.A case report of American hookworm disease detected with gastroscopy[J].J Pathog Biol,2021,16(6):743-744. [15] 潘金仁,余可根,张玲玲,等.浙江南部山区钩虫感染因素分析及健康影响初步调查[J].中华地方病学杂志,2019,38(8):658-662. PAN J R,YU K G,ZHANG L L,et al.Preliminary investigation on the influencing factors and health impacts of hookworm infection in south mountain area of Zhejiang Province[J].Chin J Endemiol,2019,38(8):658-662.
