Case Report and Literature Review: Nephrotic Syndrome Induced by Hookworm Infection

Hookworm-induced nephrotic syndrome (NS) is relatively rare. Hookworm infections have diverse manifestations. Mild cases may be asymptomatic, while severe ones can cause severe anemia, coagulation disorders, and protein deficiency. Both late-stage NS and hookworm infection present with similar clinical manifestations, such as anemia and hypoproteinemia. Hypoproteinemia can easily cause edema, posing a potential diagnostic challenge in clinical settings. Hookworm infection may significantly impact kidney function through complex immunopathological mechanisms. Specifically, hookworm infection can trigger abnormal immune responses, leading to kidney damage and inflammation. Prolonged infection may also lead to the deposition of immune complexes in the kidney, potentially causing severe kidney impairment. This report introduces a case of a healthy female in her fifties who developed NS after a hookworm infection. After receiving anti-hookworm and integrated traditional Chinese medicine (TCM) and Western medicine treatment, the patient's bilateral lower limb edema gradually resolved, and she was discharged from the hospital. A retrospective analysis of 9 hookworm-induced NS patients showed 5 complete remissions, 2 partial remissions, and 2 relapses after comprehensive treatment.No recurrence occurred in remaining patients during 3-24 months follow-up.The study found that hookworm infection may be an important trigger for NS, especially in endemic areas. For patients with unexplained NS, screening for hookworm infection should be considered. Timely diagnosis and treatment of hookworm infection may significantly improve the prognosis of NS.