Anatomical patterns of intrahepatic cystic echinococcosis in reference to serological and clinical findings

Abstract

Background: Cystic echinococcosis (CE) is a zoonotic infection that occurs worldwide, particularly in endemic areas in the Middle East, including Egypt. Echinococcus granulosus (E. granulosus) eggs can be accidentally ingested by human in contaminated food or drinks and reach primarily the liver forming hydatid cysts with reported predilection for the right lobe. However, the segmental orientation of hepatic echinococcosis in the light of the clinical presentation and serological findings needs further investigation as such correlation may carry additional clues to guide the therapeutic management and prognostic outcomes. Objectives: The present study was designed to determine the relation of anatomical location of intrahepatic hydatid cyst to its development, activity, and host immune response; as well as its potential extrahepatic spread. Patients and Methods: A total of 46 patients having liver hydatid cysts were evaluated. Intrahepatic cysts were categorized according to Couinaud's segments by ultrasound examination; and analysis was done regarding cyst size, cyst staging and activity, and extrahepatic spread, in addition to clinical features and patterns of IgG level using two serodiagnostic tests IHA and ELISA. Results: Hydatid cysts were found in all segments with the exception of segment I. Active cysts were mostly found in segment VII (no. = 11; 47.8%), recording a large diameter size with a mean of 6.55 cm. Inactive cysts recorded statistically significant smaller diameters with a mean of 5.55 cm denoting cyst evolution and degeneration. Serum antibody level correlated significantly with radiological profile of cysts activity in the studied population. Finally, extrahepatic spread was observed in hydatid cysts involving all liver segments with the exception of segment V. Conclusion: Hydatid cysts were found in liver segments II through to VIII. While cysts in segment VII demonstrated large sized active cysts with extrahepatic spread, cysts confined to segment V pose minimal risk for extrahepatic spread.

Does the expression of granzyme B participate in inflammation, fibrosis, and fertility of hydatid cysts?

“…Serology has relatively low sensitivity and specificity, making them complementary diagnostic tools (Santivañez et al 2012 ). The absence of local strains for CE detection could result in its limited validity (El-Sherbini et al 2020 ).…”

“…False-negative results are reported in small, intact cysts, extrahepatic locations, or non-viable cysts (Sarkari and Rezaei 2015 ). The compromised immune response is attributed to the decay of the germinative membrane, and the potential negative outcomes may arise from the calcification of non-fertile cysts (El-Sherbini et al 2020 ).…”

Metal Ion–Peptide-Intermediated Ligand Transfer for Serum Detection of the Omicron Variant of SARS-Cov-2 in Echinococcosis Patients

“…Common chronic diseases such as chronic inflammation, diabetes, and cardiovascular conditions can now be relatively easily detected early on. However, other more obscure chronic conditions are hard to detect in time, such as being infected by the tapeworm (Echinococcus granulosus), which often results in cysts residing in the bones, difficult to detect. − Therefore, here, an attempt is made to design a new method of virus detection for evaluating the infection of the omicron variant in Echinococcosis (cyst-bearing) patients. As a recent case report alerted that some symptoms of cysts may be wrongly interpreted as accurate infection by the virus, leading to potentially fatal results …”