Toxocara canis infection: Unusual trigger of systemic lupus erythematosus

Infection by Toxocara canis can cause systemic vasculitis. We report here a unique case of systemic lupus erythematosus (SLE) triggered by T. canis infection. An 8‐year‐old girl was treated with albendazole therapy for common toxocariasis, but she developed two weeks later, asthenia, fever, infiltrated maculopapular eruption of the face, peripheral vascular disease with necrosis of the fingers and inflammatory anemia with proteinuria. Anti‐nuclear, anti‐DNA and anti‐Sm antibodies positivity, together with minimal change nephritis with mesangial exclusive IgM deposit on renal biopsy and clinical relapse after initially successful steroid therapy, led to the diagnosis of SLE. T. canis infection can trigger systemic lupus but must also be ruled out of the differential diagnosis given its association with autoimmunity.

[1]  E. Bonfá,et al.  Update on infections and vaccinations in systemic lupus erythematosus and Sjögren's syndrome , 2014, Current opinion in rheumatology.

[2]  W. Lo,et al.  Minimal mesangial lupus nephritis: a systematic review , 2010, Scandinavian journal of rheumatology.

[3]  S. Kaya,et al.  [Investigation of the presence of autoantibodies in patients with toxocariasis]. , 2009, Mikrobiyoloji bulteni.

[4]  A. Doria,et al.  Infections as triggers and complications of systemic lupus erythematosus. , 2008, Autoimmunity reviews.

[5]  M. Roussou,et al.  Nephrotic syndrome as a manifestation of Toxocara canis infection. , 2006, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[6]  F. Lhote Vascularites systémiques au cours de parasitoses , 2004 .

[7]  H. Auer,et al.  Association of autoantibodies against small nuclear ribonucleoproteins (snRNPs) with symptomatic Toxocara canis infestation , 2004, Parasite immunology.

[8]  F. Lhôte [Systemic vasculitis during parasitosis]. , 2004, Presse medicale.

[9]  D. Despommier,et al.  Toxocariasis: Clinical Aspects, Epidemiology, Medical Ecology, and Molecular Aspects , 2003, Clinical Microbiology Reviews.

[10]  A. Shetty,et al.  Nephrotic syndrome associated with Toxocara canis infection. , 1999, Annals of tropical paediatrics.

[11]  F. Abramo,et al.  Renal involvement in mice experimentally infected with Toxocara canis embryonated eggs. , 1992, Veterinary parasitology.