Alveolar echinococcosis of the liver: a single center experience

Abstract

INTROduCTION In humans, alveolar echinococcosis (AE) of the liver is caused by canine tapeworm called Echinococcus multilocularis. The disease is most prevalent in the northern hemisphere and in the eastern part of Turkey. ObjECTIvEs The aim of the study was to review the natural history of AE and its clinical and radiological features. PATIENTs ANd mEThOds The retrospective study involved 23 patients (10 men, 13 women), aged 34-75 years with AE who had been referred to our liver disease clinic in the past 4 years. Only patients with pathologically proven AE were included in the study. The sociodemographic, clinical, and radiological features of AE were also evaluated. REsuLTs The main laboratory characteristics of AE included mild eosinophilic leukocytosis with hypergammaglobulinemia, elevated C-reactive protein levels, near-normal liver transaminases, and increased levels of cholestatic enzymes and immunoglobulin E. Eight patients (35%) had hepatitis B e antigen-negative hepatitis B infection. Budd-Chiari syndrome was identified in 3 of 23 patients (13%). Eighty-three percent of the patients had a seropositive test result for AE, and approximately one-third of the patients had distant metastasis. Surgical treatment was administered in 4 patients. Four patients died due to complications during follow-up. CONCLusIONs Patients with AE have numerous complications and advanced disease at the time of diagnosis. The clinical picture of AE comprises a number of hepatic and extrahepatic disturbances related both to destructive and mass effects of the tapeworm.

Application of Multi-Slice Computed Tomography for the Preoperative Diagnosis and Classification of Pulmonary Cystic Echinococcosis

“…Ozyurtkan et al [ 6 ] found that elevated leukocytes are more common in cases with hydatid cyst rupture. In the present study, 100% (9/9) of cases with leukocytosis had cyst rupture, which is consistent with previous findings [ 6 , 11 ] and indicates the presence of secondary infection of the CE3 lesion through cyst wall rupture. Parallel infections might have influenced measured blood parameters such as leucocyte count.…”

Eosinophilia in Infectious Diseases

“…Less commonly, cysts develop in the lungs causing respiratory symptoms or pain [99]. E. multilocularis is associated with eosinophilia less frequently that with E. granulosis , but rarely, mild eosinophil elevations may be seen [111-114]. …”

Management of Advanced Hepatic Alveolar Echinococcosis: Report of 42 Cases

“…The treatment of the advanced HAE, especially the necessity of aggressive operations, is disputed. [15][16][17] In the retrospective study, we analyzed 42 patients with advanced HAE treated with palliative resection, palliative nonresective procedures, OLT, or albendazole therapy alone. These patients were not randomized and that treatments were based on disease presentations, individual wishes, and physician choices as well.…”

“…The management of advanced HAE, especially the necessity of aggressive operations, like palliative resection and orthotopic liver transplantation (OLT), remains controversial. [15][16][17] …”