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Giardia lamblia — Ursache von Urtikaria und Pruritus oder zufällige Assoziation?

Giardia lamblia — cause of urticaria and pruritus or accidental association?

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Zusammenfassung

Bei 3 Patienten mit chronisch-rezidivierender Urtikaria bzw. Pruritus wurden bei der mikrobiologischen Stuhluntersuchung vegetative Formen des Darmparasiten Giardia lamblia sowie die hochinfektiösen Lamblienzysten gefunden. Eine Behandlung der asymptomatischen intestinalen Lamblienmanifestation mit Metronidazol per os bzw. Tinidazol per os war erfolgreich und führte zur Heilung der Hauterkrankung, bei dem Patienten mit Pruritus kam es zu einer deutlichen Besserung der Symptome.

Lamblien (Giardia lamblia/Giardia intestinalis) verursachen in der Regel eine akute oder chronische Diarrhoe. Kutane Manifestationen sind selten, wenn, dann treten sie als Folge eines infektallergischen Geschehens im Sinne einer Urtikaria, von Pruritus und auch eines atopischen Ekzems, im Einzelfall auch als chronisches Analekzem auf.

Auf einen kausalen Zusammenhang zwischen intestinaler Parasitose und urtikariellen bzw. pruritischen Symptomen muss aufgrund des mikroskopische Nachweises von Lamblienzysten sowie von Giardia lamblia-Antigen im Stuhl mittels Elisa und ex juvantibus wegen des Therapieerfolges mit Metronidazol bzw. Tinidazol geschlossen werden.

Abstract

Three patients with chronic urticaria or pruritus were found to suffer from an asymptomatic intestinal infection caused by the protozoan Giardia lamblia. Treatment with metronidazole per os or tinidazole per os was successful; the pruritic symptoms in one patient improved markedly.

Giardia lamblia (Giardia intestinalis) are enteroparasites and produce gastrointestinal symptoms such as acute and chronic diarrhea. Cutaneous manifestations associated with giardiasis occur extremely rarely. Urticaria and itching may be explained as an infection-associated allergy. Hitherto, the following cutaneous signs have been described: urticaria, angioedema, mouth ulcers, pruritus, atopic dermatitis, and anal eczema.

We considered that the cutaneous manifestations described here, i. e., urticaria and itching, were secondary to the associated gastrointestinal infection due to Giardia lamblia cysts and trophozoite forms, as they disappeared under specific treatment with metronidazole or tinidazole.

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Authors and Affiliations

  1. Laboratorium für medizinische Mikrobiologie, Mölbis

    P. Nenoff & J. Herrmann

  2. Hautarztpraxis, Leipzig-Engelsdorf

    E. Domula

  3. Hautarztpraxis, Leipzig

    U. Willing

  4. Laboratorium für medizinische Mikrobiologie, Straße des Friedens 8, 04579, Mölbis

    P. Nenoff

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  1. P. Nenoff
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  2. E. Domula
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  3. U. Willing
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  4. J. Herrmann
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Correspondence to P. Nenoff.

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Nenoff, P., Domula, E., Willing, U. et al. Giardia lamblia — Ursache von Urtikaria und Pruritus oder zufällige Assoziation?. Hautarzt 57, 518–522 (2006). https://doi.org/10.1007/s00105-005-0959-9

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  • DOI: https://doi.org/10.1007/s00105-005-0959-9

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