Alveolar Echinococcosis of the Liver

Kasai, Yoichi; Koshino, I; Kawanishi, Norio; Sakamoto, Hitoshi; Sasaki, Eisei; Kumagai, Mitsuru

doi:10.1097/00000658-198002000-00003

Cited by 66 publications

(33 citation statements)

References 7 publications

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“…Early diagnosis of persons with asymptomatic echinococcosis is considered a prerequisite for efficient management and treatment of the disease (71). Consequently, serological screening has been offered to populations and communities in many areas.…”

Section: Immunology Definitive Hostsmentioning

confidence: 99%

Molecular and immunological diagnosis of echinococcosis

Gottstein

1992

Clin Microbiol Rev

125

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Echinococcosis is an infectious disease of humans caused by the larval (metacestode) stage of the cestode species Echinococcus granulosus (cystic echinococcosis or hydatid disease) or Echinococcus multilocularis (alveolar echinococcosis or alveolar hydatid disease). Clinical manifestations depend primarily on localization and size of hepatic lesions and may include hepatomegaly, obstructive jaundice, or cholangitis. Prognostically, alveolar echinococcosis is considered similar to liver malignancies, including a lethality rate of 90% for untreated cases. Diagnosis is based on imaging techniques coupled with immunodiagnostic procedures. Antibody detection tests for E. multilocularis have markedly improved with the use of affinity-purified Em2 antigen and recombinant antigen II/3-10 in enzyme immunoassays. Antigens of corresponding quality for E. granulosus are still unavailable. The detection of circulating antigens and immune complexes in the sera of patients with cystic echinococcosis, the demonstration of in vitro lymphocyte proliferation in response to stimulation with Echinococcus antigens, and the discrimination of serum immunoglobulin isotype activity to various Echinococcus antigens in both cystic and alveolar echinococcosis have been suggested for diagnostic purposes as well as for monitoring patients after treatment. New diagnostic molecular tools include DNA probes for Southern hybridization tests and polymerase chain reaction for the amplification of E. multilocularis and E. granulosus species-specific DNA fragments.

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Section: Immunology Definitive Hostsmentioning

confidence: 99%

Molecular and immunological diagnosis of echinococcosis

Gottstein

1992

Clin Microbiol Rev

125

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“…11 A multicystic tumor mass in the liver, contrasting with a well-preserved general condition, is the common presentation of AHD. 16 Contrary to E granulosus, AHD is not associated with containment of the lesions by reactive fibrosis. Consequently, the lesions extend progressively to the hepatic hilum and can result in several serious clinical manifestations, such as angiocholitis, portal hypertension and the Budd-Chiari syndrome.…”

Section: Discussionmentioning

confidence: 93%

“…Consequently, the lesions extend progressively to the hepatic hilum and can result in several serious clinical manifestations, such as angiocholitis, portal hypertension and the Budd-Chiari syndrome. 16 Extension to the peritoneum, duodenum and pancreas is also possible. 14 Distant disemination occurs in 10% of cases, especially to the lungs and, less frequently, the brain.…”

Section: Discussionmentioning

confidence: 99%

Cytologic Diagnosis of Isolated Pancreatic Alveolar Hydatid Disease with Immunologic and PCR Analyses

Diebold-Berger

Khan²,

Gottstein³

et al. 1997

Acta Cytologica

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“…Unfortunately, this approach cannot be implemented in a significant majority of the patients as reflected by the wide spectrum of the resectability rates reported in the literature (4–87%) [7, 8, 9, 10, 11, 20, 21]. Because symptomatic patients usually have advanced lesions [22], the key to success is population screening in high-risk areas until public health measures eliminate the endemicity in the region [7, 8, 9, 10, 11]. A remarkable result is the 87% resectability rate reported by Uchino et al [7].…”

Section: Discussionmentioning

confidence: 99%

“…The resectability rates reported in the literature vary between 4 and 87% and generally reflect disease stage at presentation [7, 8, 9, 10, 11]. Although Turkey is also in an endemic region, population screening is not performed.…”

Section: Introductionmentioning

confidence: 99%

Alveolar Echinococcosis in Turkey

et al. 2003

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Background: Radical resection is the only potentially curative treatment for hepatic alveolar echinococcosis (AE). Although Turkey is an endemic region, population screening is not performed and early diagnosis is rare. Consequently, surgeons are compelled to explore possibilities such as near-total resection and biliodigestive anastomosis for palliation of jaundice. Methods: Surgery was performed in 32 patients with hepatic AE with the following indications: (1) resection; (2) palliation of jaundice; (3) definite assessment of operability; (4) failure in the management of cavity infection by percutaneous methods. Curative resection (R0 = complete resection of all parasitic mass [n = 9], and R1 = a resection in which a small remnant was left on a vital structure [n = 8]) were performed in 17 patients, intrahepatic cholangiojejunostomy in 7, laparotomy-external drainage in 7, and debulking in 1. Results: Perioperative mortality rates were 2/17, 0/7, 2/7 and 1/1, respectively. Twelve patients in the curative resection group are alive without recurrence/progression of the small remnant during a median follow-up of 59 (range 27–116) months. One patient developed an inoperable recurrence that was treated with albendazole. One patient was lost to follow-up. Long-term albendazole treatment was effective in all R1 patients except a patient who had slow asymptomatic progression. Successful palliation of jaundice was achieved in 5 of the 7 intrahepatic cholangiojejunostomy patients. Conclusions: The results of R1 resection in alveolar hydatid disease are similar to those of R0 resection; a small remnant is successfully controlled by albendazole. In patients with jaundice due to hilar invasion, biliary diversion from segment 3 or 5 is effective for palliation of the jaundice and facilitates albendazole treatment.

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Alveolar Echinococcosis of the Liver

Cited by 66 publications

References 7 publications

Molecular and immunological diagnosis of echinococcosis

Molecular and immunological diagnosis of echinococcosis

Cytologic Diagnosis of Isolated Pancreatic Alveolar Hydatid Disease with Immunologic and PCR Analyses

Alveolar Echinococcosis in Turkey

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