Aneamia

Undiagnosed for over 2 years, this 14-year-old Uttarakhand boy lost 22 litres of blood due to hookworms
In an unusual case, a 14-year-old boy lost 22 litres of blood in over two years due to blood-sucking hookworms lurking in his small intestine.

The incident came to light when the patient from Uttarakhand's Haldwani India was brought to Delhi's Sir Ganaga Ram Hospital six months ago with two episodes of passage of blood in stools. It was due to hookworm manifestation in his body that he went through iron deficiency anaemia for a long time.

The rare medical case has been published in the latest edition of Journal of Infectious Diseases and Therapy.

"The child was suffering from iron deficiency anaemia for the last two years. He was being managed with repeated blood transfusions and received 50 units (22 litres) of blood transfusions in the last two years," said Anil Arora, Chairperson of Gasreroenterology Department at SRGH.

Arora said the patient's diagnosis could not be established despite various repeated tests including esophagogastroduodenoscopy (EGD), colonoscopy and radiographic studies of the intestine.

The patient's haemoglobin was low at 5.86. As the problem persisted and there was gastrointestinal bleeding, the doctor decided to go for the rarely-used Capsule endoscopy.

Calling the findings "shocking", Arora said: "We could see multiple hookworms buried in small intestine and were seen actively sucking blood with dancing movements. "Sucked blood could be seen in the cavity of hookworms, giving red colour to them. White coloured hookworms who had not yet sucked blood were seen lying quiet in the small bowel."

"After treatment the child recovered and his haemoglobin increased to 11 gm/dl," said Arora, describing the health condition of the patient.

"Conventionally, hookworm infestation is found commonly in Asian population. Manifestation of hookworms can be prevented by avoiding barefoot walking and maintenance of food hygiene," he said.