Allergy Asthma Respir Dis.  2016 May;4(3):217-220. 10.4168/aard.2016.4.3.217.

Transient global amnesia associated with toxocariasis and secondary hypereosinophilia

• Ahn YE
• Bae S
• Jeong YJ
• Park SY
• Shin B
• Kim TB
• Cho YS
• Moon HB
• Kwon HS

• KMID: 2165085
• DOI: http://doi.org/10.4168/aard.2016.4.3.217

Abstract

Toxocariasis is an important cause of secondary hypereosinophilia in Korea. Here, we describe a rare case of toxocariasis presenting as transient global amnesia due to secondary hypereosinophilia. A 44-year-old male visited the Emergency Department (ED) for transient global amnesia. He ate raw cow liver and omasum 2 weeks before the ED visit. The initial peripheral blood eosinophil count was 15,250/µL and serologic test for serum specific IgG antibodies to Toxocara canis larval antigen was positive. Radiologic studies revealed multiple small embolic infarctions of brainwithout cardioembolic sources or vascular abnormalities. He was treated with systemic corticosteroid, and neither neurologic deficit nor motor deficit was left. In our current case, the patient have a history of frequently eating raw cow liver and omasum, and his total IgE level was extremely high (>5,000 IU/mL). Thus, the patient was diagnosed as having toxocariasis and secondary hypereosinophilia. Toxocariasis should be considered in the differential diagnosis in patients with eosinophilia and atypical neurologic symptoms, such as transient amnesia.

Keyword

Toxocariasis; Eosinophilia; Cerebral infarction; Amnesia

MeSH Terms

Adult
Amnesia
Amnesia, Transient Global*
Antibodies
Cerebral Infarction
Diagnosis, Differential
Eating
Emergency Service, Hospital
Eosinophilia
Eosinophils
Humans
Immunoglobulin E
Immunoglobulin G
Infarction
Korea
Liver
Male
Neurologic Manifestations
Omasum
Serologic Tests
Toxocara canis
Toxocariasis*
Antibodies
Immunoglobulin E
Immunoglobulin G

Figure

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  Fig. 1 Diffusion-weighted magnetic resonance imaging showing multiple high-signal intensities in both cerebral and cerebellar hemispheres.

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  Fig. 2 Computed tomography scan showing multiple ill-defined nodules in both lungs and multiple ill-defined, irregular, low-density lesions in both hepatic lobes.

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  Fig. 3 The patient's eosinophilic response and glucocorticoid dosage during hospitalization. mPD, methylprednisolone.

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