SYSTEMIC STRONGYLOIDIASIS IN A HUMAN T-LYMPHOTROPIC VIRUS TYPE-1-POSITIVE MAN PRESENTING AS CHRONIC-PANCREATITIS WITH A PANCREATICOBILIARY STRICTURE

Objective: To report an unusual case of systemic strongyloidiasis and to highlight the close association of this condition with human T-lymp hotropic virus type 1 (HTLV-1) infection in patients from endemic area s. Patient: A 62-year-old West Indian man, resident in the United King dom since 1965 and consuming 200 units of alcohol per week, presented with symptoms of chronic pancreatitis and evidence of malabsorption. h e had a tight pancreatico-biliary stricture on endoscopic retrograde c holangio-pancreatography. Pancreatic duct brushings and duodenal and r ectal biopsies confirmed invasive stronglyoidiasis. Interventions: Pan creatic duct stenting provided immediate relief of post-prandial pain. Combination anti-helminthic therapy with thiabendazole and albendazol e rapidly improved the malabsorption. Outcome: The patient remains wel l and symptom-free 2 years later, despite continued alcohol abuse. Con clusions: Systemic strongyloidiasis should be included in the differen tial diagnosis of patients originating from endemic areas who present with malabsorption. Their HTLV-1 status should also be established bec ause of the close association between the two conditions.