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      Giardiasis Presenting as a Brunner Gland Hyperplasia

      case-report
      Author(s): , MD 1 , , MD 2 ,
      Publication date (Electronic):
      Journal: ACG Case Reports Journal
      Publisher: Wolters Kluwer
      Keywords: duodenal mass, Giardia, Brunner gland hyperplasia

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          ABSTRACT

          Giardiasis is the most common intestinal parasitic disease worldwide. Clinical presentation ranges from asymptomatic to abdominal pain, diarrhea, and iron deficiency anemia. Treatment modalities include tinidazole, metronidazole, and paromomycin. We present a case of an adult man with anemia and suspected gastrointestinal bleeding who was found to have a duodenal nodule consistent with Brunner gland hyperplasia, and biopsy also showed Giardia. Limited case reports of Giardia diagnosed by duodenal biopsy are found in the literature. To the best of our knowledge, this is the first report of giardiasis presenting as Brunner gland hyperplasia.

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          Most cited references17

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          Zoonotic potential and molecular epidemiology of Giardia species and giardiasis.

          Yaoyu Feng, Lihua Xiao (2011)
          Molecular diagnostic tools have been used recently in assessing the taxonomy, zoonotic potential, and transmission of Giardia species and giardiasis in humans and animals. The results of these studies have firmly established giardiasis as a zoonotic disease, although host adaptation at the genotype and subtype levels has reduced the likelihood of zoonotic transmission. These studies have also identified variations in the distribution of Giardia duodenalis genotypes among geographic areas and between domestic and wild ruminants and differences in clinical manifestations and outbreak potentials of assemblages A and B. Nevertheless, our efforts in characterizing the molecular epidemiology of giardiasis and the roles of various animals in the transmission of human giardiasis are compromised by the lack of case-control and longitudinal cohort studies and the sampling and testing of humans and animals living in the same community, the frequent occurrence of infections with mixed genotypes and subtypes, and the apparent heterozygosity at some genetic loci for some G. duodenalis genotypes. With the increased usage of multilocus genotyping tools, the development of next-generation subtyping tools, the integration of molecular analysis in epidemiological studies, and an improved understanding of the population genetics of G. duodenalis in humans and animals, we should soon have a better appreciation of the molecular epidemiology of giardiasis, the disease burden of zoonotic transmission, the taxonomy status and virulences of various G. duodenalis genotypes, and the ecology of environmental contamination.
          Article 0 comments Cited 386 times – based on 0 reviews     Review now
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            2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea

            Andi L Shane, Rajal K. Mody, John Crump … (2017)
            These guidelines are intended for use by healthcare professionals who care for children and adults with suspected or confirmed infectious diarrhea. They are not intended to replace physician judgement regarding specific patients or clinical or public health situations. This document does not provide detailed recommendations on infection prevention and control aspects related to infectious diarrhea.
            Article 0 comments Cited 142 times – based on 0 reviews     Review now
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              Giardia lamblia infection: review of current diagnostic strategies

              Hossein Hooshyar, Parvin ROSTAMKHANI, Mohsen Arbabi … (2019)
              Giardiasis has a global distribution and it is a common cause of diarrhea in both children and adults and is transmitted via the fecal-oral route through direct or indirect ingestion of cysts. The laboratory diagnosis of Giardia spp. is mainly based on demonstration of microscopic cyst or trophozoite in stool samples but several immunological-based assays and molecular methods are also available for giardiasis diagnosis. The aim of this study was to conduct a review of the applied methods in medical laboratory and to highlight pitfalls and challenges of them for diagnosis of giardiasis. In this article we have evaluated the Giardia diagnostic methods with a broad review of literature, electronic databases and books. The search has covered the articles and some textbooks that have published up to 2018. It has been concluded that traditional microscopy combination with stool concentration method should still be held in the routine medical laboratory due to economical and high sensitivity and immunological-based assay and molecular methods which are recommended to use as a complementary test to the traditional technique.
              Article 0 comments Cited 38 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Alvaro J. Vivas
                Journal
                Journal ID (nlm-ta): ACG Case Rep J
                Journal ID (iso-abbrev): ACG Case Rep J
                Journal ID (coden): ACGCRJ
                Journal ID (publisher-id): AC9
                Title: ACG Case Reports Journal
                Publisher: Wolters Kluwer (Maryland, MD )
                ISSN (Electronic): 2326-3253
                Publication date Collection: June 2024
                Publication date (Electronic): 14 June 2024
                Volume: 11
                Issue: 6
                Electronic Location Identifier: e01386
                Affiliations
                [1 ]Department of Internal Medicine, Universidad Icesi, Medical School, Cali, Colombia
                [2 ]Division of Digestive Diseases and Nutrition, University of South Florida Morsani College of Medicine, Tampa, FL
                Author notes
                Correspondence: Pushpak Taunk, MD ( ptaunk@ 123456usf.edu ).
                Article
                Publisher ID: ACGCR-24-0115 Accession ID: 00015
                DOI: 10.14309/crj.0000000000001386
                PMC ID: 11177821
                PubMed ID: 38883578
                SO-VID: 156c3242-47d6-476e-84b1-0dcd19434b8f
                Copyright © © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

                History
                Date received : 13 February 2024
                Date accepted : 07 May 2024
                Categories
                Subject: Case Report
                Subject: Pathology
                Custom metadata
                OPEN-ACCESS TRUE

                Keywords: duodenal mass,giardia,brunner gland hyperplasia
                Data availability:
                Keywords: duodenal mass, giardia, brunner gland hyperplasia

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