Liver schistosomiasis: an unexpected finding in hepatitis B virus-related chronic hepatitis

Ranalli, Teresa Valentina; Dell’Isola, Serena; Gomes, Vito; Ialungo, Anna Maria; Starnini, Giulio; Roselli, Paola; Ghittoni, Giorgia; Caturelli, Eugenio

doi:10.1016/j.ijid.2008.04.013

Cited by 2 publications

(1 citation statement)

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“…The ova of S. mansoni and S. japonicum reach the liver via the portal venous system and cause inflammation, leading to fibrosis and portal hypertension. It is possible to see schistosome ova on liver histology, but this has rarely been reported in the literature [1]. We present the case of a 38-year-old Chinese man with dual pathology of HBV e-antigen seroconversion causing acute liver inflammation and hepatic S. japonicum found incidentally on a liver biopsy.…”

Section: Introductionmentioning

confidence: 98%

Schistosomiasis japonicum diagnosed on liver biopsy in a patient with hepatitis B co-infection: a case report

et al. 2014

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IntroductionChronic hepatitis B virus and schistosomiasis are independently associated with significant mortality and morbidity worldwide. Despite much geographic overlap between these conditions and no reason why co-infection should not exist, we present what is, to the best of our knowledge, the first published report of a proven histological diagnosis of hepatic Schistosomiasis japonicum and chronic hepatitis B co-infection. A single case of hepatitis B and hepatic Schistosomiasis mansoni diagnosed by liver biopsy has previously been reported in the literature.Case presentationA 38-year-old Chinese man with known chronic hepatitis B virus infection presented with malaise, nausea and headache. Blood tests revealed increased transaminases and serology in keeping with hepatitis B virus e-antigen seroconversion. A liver biopsy was performed because some investigations, particularly transient elastography, suggested cirrhosis. Two schistosome ova were seen on liver histology, identified as S. japonicum, probably acquired in China as a youth. His peripheral eosinophil count was normal, schistosomal serology and stool microscopy for ova, cysts and parasites were negative.ConclusionHepatic schistosomiasis co-infection should be considered in patients with hepatitis B virus infection who are from countries endemic for schistosomiasis. Screening for schistosomiasis using a peripheral eosinophil count, schistosomal serology and stool microscopy may be negative despite infection, therefore presumptive treatment could be considered. Transient elastography should not be used to assess liver fibrosis during acute flares of viral hepatitis because readings are falsely elevated. The impact of hepatic schistosomiasis on the sensitivity and specificity of transient elastography measurement for the assessment of hepatitis B is as yet unknown.

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Section: Introductionmentioning

confidence: 98%

Schistosomiasis japonicum diagnosed on liver biopsy in a patient with hepatitis B co-infection: a case report

et al. 2014

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Hepatosplenic schistosomiasis: playing hide-and-seek with an elusive parasite

et al. 2017

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A 27-year-old man of Eritrean origin presented with persistent left-sided abdominal pain. Initial investigation showed signs of liver fibrosis, portal hypertension and splenomegaly. A diagnosis of hepatosplenic schistosomiasis was suspected on grounds of elevated total IgE, grey area antischistosomiasis antibodies and the high endemic status of his native country. However, repeated microscopy of faecal and urine samples, as well as rectal biopsies, failed to demonstrate schistosomal eggs. Finally, the diagnosis of hepatosplenic schistosomiasis was established through demonstration of a egg in a liver biopsy taken in an attempt to clarify the cause of the above findings. The patient had recently been treated for uncomplicated malaria. Lowered schistosomiasis worm/egg burden and hence reduced sensitivity of classic microscopy-based schistosomiasis testing was attributed to the antischistosomal activity of the antimalarial chemotherapy.

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Liver schistosomiasis: an unexpected finding in hepatitis B virus-related chronic hepatitis

Cited by 2 publications

References 11 publications

Schistosomiasis japonicum diagnosed on liver biopsy in a patient with hepatitis B co-infection: a case report

Schistosomiasis japonicum diagnosed on liver biopsy in a patient with hepatitis B co-infection: a case report

Hepatosplenic schistosomiasis: playing hide-and-seek with an elusive parasite

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