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Hookworm infections as well as other intestinal nematodiases are endemic in China. In this case, a 70-year-old male showed symptoms of chest tightness, shortness of breath, and both lower extremities edema. The diagnostic result was chronic renal insufficiency, chronic kidney disease (5th stage), and renal anemia at first. Then, he received treatment with traditional drugs. However, this treatment did not help to alleviate the symptoms of the patient significantly. The results of gastroendoscopy showed hookworms in the duodenum, also confirmed by pathology examination. Anemia was markedly ameliorated after eliminating the parasites. The results mentioned above suggested that ancylostomiasis was the leading causes of anemia in this patient, and the etiology of anemia in uremic patients should be systematically considered. Especially when anemia could not be cured by regular treatments, rare diseases should be investigated.

Laurence Moon Bardet Biedl Syndrome is a rare genetic disorder. Consanguineous marriage is usually the common cause. Principal features of Bardet Biedl Syndrome are red cone dystrophy, obesity, polydactyl, hypogonadism and renal anomalies. The diagnosis was overlooked in our patient until he came in our hospital. We here report an infrequent case of autosomal recessive disorder with Anaemia.

Background: Relative contribution of these infections on anemia in pregnancy is not certain. While measures to protect pregnant women against malaria have been scaling up, interventions against helminthes have received much less attention. In this study, we determine the relative impact of helminthes and malaria on maternal anemia., Methods: A prospective observational study was conducted in coastal Kenya among a cohort of pregnant women who were recruited at their first antenatal care (ANC) visit and tested for malaria, hookworm, and other parasitic infections and anemia at enrollment. All women enrolled in the study received presumptive treatment with sulfadoxine-pyrimethamine, iron and multi-vitamins and women diagnosed with helminthic infections were treated with albendazole. Women delivering a live, term birth, were also tested for maternal anemia, fetal anemia and presence of infection at delivery., Principal Findings: Of the 706 women studied, at the first ANC visit, 27% had moderate/severe anemia and 71% of women were anemic overall. The infections with highest prevalence were hookworm (24%), urogenital schistosomiasis (17%), trichuria (10%), and malaria (9%). In adjusted and unadjusted analyses, moderate/severe anemia at first ANC visit was associated with the higher intensities of hookworm and P. falciparum microscopy-malaria infections. At delivery, 34% of women had moderate/severe anemia and 18% of infants' cord hemoglobin was consistent with fetal anemia. While none of the maternal infections were significantly associated with fetal anemia, moderate/severe maternal anemia was associated with fetal anemia., Conclusions: More than one quarter of women receiving standard ANC with IPTp for malaria had moderate/severe anemia in pregnancy and high rates of parasitic infection. Thus, addressing the role of co-infections, such as hookworm, as well as under-nutrition, and their contribution to anemia is needed.

Little data are available regarding the association of ancylostomiasis with overt gastrointestinal bleeding. This 6-year retrospective study describes the clinical and biological profiles of unexpectedly identified ancylostomiasis in a 4-month-old baby and four adults; they presented with melena and were referred for urgent diagnostic gastrointestinal endoscopy, which confirmed numerous small intestine injuries with surrounding blood pools caused by Ancylostoma duodenale worms. Gastric erosions were also encountered in one patient. Uniquely, worm biological activities were recorded live in vivo, including mucosal invasion through a vigorous, rapid piercing process, repeated bloodsucking habits, and gut appearance during the stages of feeding, digestion, and excretion in male and female worms. In conclusion, ancylostomiasis-induced melena may occur in all ages from infants to the elderly. Worm bloodfeeding occurs after quick mucosal piercing, with blood loss being aggravated by a repeated feeding behavior. After treatment is started, bleeding stops rapidly in response to anthelmintic therapy.

Background: Hookworm infections are an important cause of (severe) anemia and iron deficiency in children in the tropics. Type of hookworm species (Ancylostoma duodenale or Necator americanus) and infection load are considered associated with disease burden, although these parameters are rarely assessed due to limitations of currently used diagnostic methods. Using multiplex real-time PCR, we evaluated hookworm species-specific prevalence, infection load and their contribution towards severe anemia and iron deficiency in pre-school children in Malawi., Methodology and Findings: A. duodenale and N. americanus DNA loads were determined in 830 fecal samples of pre-school children participating in a case control study investigating severe anemia. Using multiplex real-time PCR, hookworm infections were found in 34.1% of the severely anemic cases and in 27.0% of the non-severely anemic controls (p<0.05) whereas a 5.6% hookworm prevalence was detected by microscopy. Prevalence of A. duodenale and N. americanus was 26.1% and 4.9% respectively. Moderate and high load A. duodenale infections were positively associated with severe anemia (adjusted odds ratio: 2.49 (95%CI 1.16-5.33) and 9.04 (95%CI 2.52-32.47) respectively). Iron deficiency (assessed through bone marrow examination) was positively associated with intensity of A. duodenale infection (adjusted odds ratio: 3.63 (95%CI 1.18-11.20); 16.98 (95%CI 3.88-74.35) and 44.91 (95%CI 5.23-385.77) for low, moderate and high load respectively)., Conclusions/significance: This is the first report assessing the association of hookworm load and species differentiation with severe anemia and bone marrow iron deficiency. By revealing a much higher than expected prevalence of A. duodenale and its significant and load-dependent association with severe anemia and iron deficiency in pre-school children in Malawi, we demonstrated the need for quantitative and species-specific screening of hookworm infections. Multiplex real-time PCR is a powerful diagnostic tool for public health research to combat (severe) anemia and iron deficiency in children living in resource poor settings.

A full-length cDNA encoding an anticoagulant peptide, named AduNAP4, was cloned and identified from the human hookworm Ancylostoma duodenale. AduNAP4 has 104 amino acids including a predicted 23-residue signal peptide and shows

In this study, a patient who was hospitalized with a severe anemia in the Internal Medicine Clinic of the Health Research and Application Hospital of Yüzüncü Yil University for one week is presented. The patient had fatigue, paleness and dizziness for one month and approximately 12 kg weight lost for four mounts previous to admission.. Severe iron deficiency anemia was diagnosed in the patient by laboratory analyses. Because there were no hematologic factors associated with severe anemia, the stool examination was also performed. In the Parasitology Laboratory, stool microscopy of the patient revealed numerous ova of hookworm. General condition of the patient well improved with anti-parasitic and anti-anemia treatment. It was concluded that patients with iron deficiency anemia diagnosed in health centers should be also examined for the intestinal parasitic diseases encountered rarely, and physicians should consider non-endemic parasitic diseases in their provinces.

The larva of hookworm matures into the adult stage in the small intestine, causing chronic intestinal blood loss and iron-deficiency anemia. Hookworm infestation of colon has not been reported previously. We report a 35-year-old man who presented with diarrhea with blood and mucus in stools. Colonoscopy revealed several hookworms in the colon firmly adherent to the mucosa, with oozing of blood and surrounding mucosal erosions. He was treated with mebendazole and symptoms recovered completely.

Administration of 0.01 and 0.1 mg of lead nitrate for 4 and 7 days and infection of Ancylostoma caninum larvae orally altered the activation of alkaline phosphatase and acid phosphatase in the hearts of mice when compared to infected animals and controls. Alkaline phosphatase activity increased significantly in all drug-treated + infected mice. The level of acid phosphatase decreased significantly in mice exposed to chronic doses of lead. The altered levels of alkaline phosphatase and acid phosphatase suggest that administration of lead could cause toxicity in the heart, disturbing the cellular metabolism; infection alone could not cause any significant changes in enzymes of heart.

Immune-mediated haemolytic anaemia (IMHA) may be primary or secondary. In primary IMHA, no underlying cause can be found, whereas secondary IMHA is triggered by an underlying cause, such as neoplasia, infectious diseases, or drugs. This paper describes 3 dogs with typical signs of IMHA that was possibly associated with the intestinal parasite Ancylostoma caninum. As intestinal helminths can be difficult to diagnose on faecal examination, it would be pertinent to perform multiple faecal examinations on any animal that has IMHA with no apparent underlying cause, as part of the therapy.

Background: The hookworms, Ancylostoma duodenale and Necator americanus, cause significant gastrointestinal blood loss. In clinical studies, greater blood losses have been reported with A. duodenale. However, there has been no evidence that endemic A. duodenale infection has greater impact than N. americanus infection on the iron status of populations., Methods: In a sample of 525 school children in Pemba Island, Tanzania, we compared the degree of anaemia and iron deficiency associated with the two hookworm species at the individual and community (i.e. school) levels. Multiple regression was used to control for infection intensities and other child characteristics., Results: In the 492 children with hookworm positive faecal cultures, haemoglobin and ferritin concentrations decreased with increasing proportions of A. duodenale. Among children with only N. americanus larvae, the prevalence of anaemia was 60.5 % and the prevalence of ferritin <12 microg/l was 33.1%, while in children with > or =50% A. duodenale larvae, the respective prevalences were 80.6% and 58.9%. When children were grouped by the prevalence of A. duodenale at the school level, children from high prevalence (> or =20%) schools had significantly worse iron deficiency and anaemia than children from low prevalence schools., Conclusions: The species of hookworm being transmitted in a community influences the burden of iron deficiency anaemia in the community, and should be considered in prioritizing and planning programmes for hookworm and anaemia control.

The persistence and interrelationships of a recurrent group of intestinal helminth species in a coyote population from southern Texas were determined; data were collected at 4-yr intervals (1979, 1983, and 1987). The a priori expectation was that a defined recurrent group of helminth species persisted over time and that the respective helminth species were stable in terms of their abundances. The Fager index and subsequent recurrent group analysis indicated a small group of taxonomically unrelated recurring species of helminths that always demonstrated affinities with each other and occasionally with certain of the remaining species. Although there were differences across host subpopulations delineated by sex and age, temporal changes reflective of extrinsic environmental variables acting on certain helminth species appeared to have the greatest effect on recurrent group size and structure. Three of the 8 common intestinal helminth species (Ancylostoma caninum, Oncicola canis, and Alaria marcianae) occurred in all recurrent groups. Thus, there was temporal persistence of a small recurrent group of dominant helminth species that formed the basis of the intestinal helminth community in this coyote population.

A relationship between the occurrence of Mooren's ulcer and hookworm infections was suggested by Kuriakose in 1963. Sixteen patients with clinical diagnosis of Mooren's ulcer and 15 local controls from Sierra Leone were tested with respect to serum immunoglobulin levels, circulating antibody to hookworm, circulating antibodies to corneal epithelium, stool smears, and eosinophil and lymphocyte levels. Both patients and healthy controls had circulating antibodies to corneal epithelium and to hookworm. In the controls the titres of hookworm antibodies were significantly lower than in the patients, though in both groups most people had intestinal parasite infestations as detected by the stool smear. Further investigation failed to demonstrate any other significant immune alteration in the patients as compared with local controls.

The hallmark of hookworm infection, a common helminthic disease, is iron deficiency anemia. The development of anemia is dependent on the intensity of infection, the species of hookworm, and the ability of the host to resist infection and to maintain adequate stores of iron. When conditions are appropriate, the incidence of anemia caused by hookworm is high and has a significant economic impact since it results in a reduction of worker productivity. Loss of blood is caused by direct ingestion of red cells and by tissue trauma produced by worm attachment and feeding. This focal trauma may involve multiple villi and is characterized by local hemorrhage, tissue cytolysis, and neutrophilic response. Although focal intestinal lesions are apparent, their significance is questionable since diffuse mucosal changes are absent in intestinal biopsies of patients with heavy hookworm infection. Short-range control measures protecting against hookworm infection have not succeeded. Development of a vaccine against hookworm infection in humans is problematic since functional protective immunity in humans has not yet been demonstrated and no suitable animal model of hookworm infection in humans is available. At present, the most effective method of intervention appears to be supplementation of food staples with iron.

To induce chronic and continuous intestinal blood loss as therapy for congenital polycythemia in a 3 year old child, adult Ancylostoma duodenale were transferred directly from a dog to the patient via a nasoduodenal tube. By transferring adult worms, larval migration via the skin, blood and lungs--with possible attendant undesired side effects--was avoided. Furthermore, by eliminating larval migration with associated intimate tissue contact, immunogenicity was presumably reduced, and a known number of adult worms could be delivered directly to the final predilection site, the small intestine. An eosinophilic reaction of up to 23,000 cells/mm3 was observed, which may have adversely affected attempted superinfection. The relatively small numbers of parasites given on three separate occasions did not result in blood loss to a degree sufficient to eliminate the need for other forms of therapy.

Iron-deficiency anemia resulting from intestinal blood loss is the major consequence of hookworm infection. Development of the anemia can be prevented, and it can be treated by administration of iron. Hypoproteinemia, often associated with hookworm infection, may be the result of either protein malnutrition or increased intestinal loss of protein. It is unlikely that the worms cause diffuse morphologic or functional alterations of the intestine. Fortification or supplementation with iron is a practical method to control hookworm disease in endemic areas.