Severe anaemia without eosinophilia in a patient with hookworm infection in Our study –an extremely rare finding

Objective: Severe anaemia is reported to occur in severe hookworm infection in many studies. But so
far detailed study was not done to know about the occurence of severe anaemia and its relation with
eosinophilia in patients with hookworm infection found while doing upper gastro-intestinal
endoscopy. Hence a detailed study was done to know about severe anaemia and its relation with
eosinophilia in patients with hookworm infection found while doing upper gastro-intestinal
endoscopy.
Methods: A study of 1137 patients who had undergone upper gastro-intestinal endoscopy for a period
of four years and eight months from May 2009 to December 2013 was carried out .In each of these
1137 patients, the first and second part of duodenum were carefully examined to find out the presence
of hookworms. In all the patients found to have hookworms in duodenum, investigations were done to
know about the presence or absence of anaemia and severe anaemia and the presence or absence of
eosinophilia. The results were found as given below.
Results: Out of these 1137 patients, 14 patients found to have hookworms in duodenum while doing
upper gastro-intestinal endoscopy were taken into consideration for our study. Out of these14 patients
with hookworms in duodenum, 10patients were found to have eosinophilia [71%].4 patients did not
have any eosinophilia [29%].Out of these14 patients with hookworms in duodenum,9 patients had
anaemia and 2 of these 9 patients were found to have severe anaemia [haemoglobin<7g/dl or g%]. But
one patient with severe anaemia did not have eosinophilia.
Conclusion: One patient with severe anaemia with hookworm infection did not have eosinophilia.
Severe anaemia indicates significant loss of blood which will occur only due to heavy burden of
hookworms in severe hookworm infection or the late stage of hookworm infection. Hence
eosinophilia can be absent even in the late stage of hookworm infection with severe anaemia.