ネフローゼ症候群の一患者のクリプトスポリジウム症

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  • Cryptosporidial enteritis in a patient with nephrotic syndrome.
  • ネフローゼ ショウコウグン ノ 1 カンジャ ノ クリプトスポリジウムショウ

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A 5-year-old boy treated with 10-30 mg/day of prednison against nephrotic syndorme was admitted in October, 1985 because of vomiting, abdominal pain and diarrhea. He had no symptom until 7 days earlier, when diarrhea developed with the daily passage of one to 8 watery stools of moderate volume. The diarrhea continued for 6 days.<BR>Cryptosporidium oocysts were found in the stools by using Sheather's sugar flotation technique and modified Ziehl-Neelsen technique. Neither bacterial pathogens nor parasites were found in his stools.<BR>Although the case had a slight IgG deficiency due to nephrotic syndrome, no clear cut evidence of immunodeficiency could be demonstrated in the patient. The diarrhea resolved itself without any treatment. The stool was free of Cryptosporidium oocysts on day 32 after the onset.<BR>This patient's bowel problems were not caused by an opportunistic cryptosporidial infection because there was no evidence of immunosupression with corticosteroids.<BR>The patient was an urban dweller, without known close animal contact. The source of the infection in this case could not be established.<BR>His elder brother has had mild abdominal pain and diarrhea lasting 5 days at the same time, but the other family members were unaffected. Stool examinations from these family members were not done. It is possible that the elder brother may have been infected with Cryptosporidium.<BR>Meanwhile, stool samples from 112 inpatients and outpatients in Kochi Medical School were collected and examined for Cryptosporidium oocysts during the period from June to July, 1985. All stools were negative for the oocysts. These patients ranged in age from 4 months to 86 years, but the great majority of the patients were adults without diarrhea.

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