scholarly journals A Case of Hepatic Alveolar Echinococcosis Treated Radically by Hepatectomy 29 Years after Infection by Echinococcus Multilocularis

2018 ◽  
Vol 79 (10) ◽  
pp. 2145-2149
Author(s):  
Shinichi MATSUDAIRA ◽  
Yoichi ISHIZAKI ◽  
Jiro YOSHIMOTO ◽  
Hiroshi IMAMURA ◽  
Yuki FUKUMURA ◽  
...  
Keyword(s):  
Echinococcus Multilocularis ◽  
Alveolar Echinococcosis ◽  
Hepatic Alveolar Echinococcosis

Hepatic Alveolar Echinococcosis

2021 ◽  
Author(s):  
Solange Bresson-Hadni ◽  
Laurent Spahr ◽  
François Chappuis
Keyword(s):  
Access To Care ◽  
Surgical Resection ◽  
Larval Stage ◽  
Echinococcus Multilocularis ◽  
Gold Standard ◽  
Diagnostic Procedure ◽  
Alveolar Echinococcosis ◽  
Opportunistic Infections ◽  
First Line ◽  
Hepatic Alveolar Echinococcosis

AbstractHepatic alveolar echinococcosis (HAE) is a rare but severe zoonosis caused by the pseudotumoral intrahepatic development of the larval stage of the tapeworm Echinococcus multilocularis. HAE is present only in the Northern Hemisphere, predominantly in China. Currently, there is a significant resurgence of cases in historically endemic areas associated with emergence of HAE in countries not previously concerned. Today, in European countries, HAE is often discovered by chance; however, clinicians should be made aware of opportunistic infections that progressively emerged recently as a result of therapeutic or pathological immunosuppression. Ultrasonography is the key first-line diagnostic procedure, with specific serology providing confirmation in 95% of the cases. Albendazole, only parasitostatic, is the mainstay for treatment. Surgical resection, if feasible, is the gold standard for treatment, and more patients are currently eligible for this option because of an earlier diagnosis. The prognosis has considerably improved but remains poor in countries where access to care is less favorable.

scholarly journals Combining Computed Tomography and Histology Leads to an Evolutionary Concept of Hepatic Alveolar Echinococcosis

Pathogens ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 634 ◽  
Author(s):  
Johannes Grimm ◽  
Annika Beck ◽  
Juliane Nell ◽  
Julian Schmidberger ◽  
Andreas Hillenbrand ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Echinococcus Multilocularis ◽  
Alveolar Echinococcosis ◽  
Peripheral Zone ◽  
Intermediate Stage ◽  
Border Zone ◽  
Hepatic Alveolar Echinococcosis ◽  
Progression Model ◽  
Type Iv ◽  
Laminated Layer

Alveolar echinococcosis (AE) is caused by the intermediate stage of Echinococcus multilocularis. We aimed to correlate computed tomography (CT) data with histology to identify distinct characteristics for different lesion types. We classified 45 samples into five types with the Echinococcus multilocularis Ulm Classification for Computed Tomography (EMUC-CT). The various CT lesions exhibited significantly different histological parameters, which led us to propose a progression model. The initial lesion fit the CT type IV classification, which comprises a single necrotic area with the central located laminated layer, a larger distance between laminated layer and border zone, a small fibrotic peripheral zone, and few small particles of Echinococcus multilocularis (spems). Lesions could progress through CT types I, II, and III, characterized by shorter distances between laminated layer and border zone, more spems inside and surrounding the lesion, and a pronounced fibrotic rim (mostly in type III). Alternatively, lesions could converge to a highly calcified, regressive state (type V). Our results suggest that the CT types mark sequential stages of the infection, which progress over time. These distinct histological patterns advance the understanding of interactions between AE and human host; moreover, they might become prognostically and therapeutically relevant.

scholarly journals Simple liver cysts and cystoid lesions in hepatic alveolar echinococcosis: a retrospective cohort study with Hounsfield analysis

Parasite ◽  
2019 ◽  
Vol 26 ◽  
pp. 54 ◽  
Author(s):  
Agata Engler ◽  
Rong Shi ◽  
Meinrad Beer ◽  
Julian Schmidberger ◽  
Wolfgang Kratzer ◽  
...  
Keyword(s):  
Echinococcus Multilocularis ◽  
Alveolar Echinococcosis ◽  
Morphological Characteristics ◽  
Hounsfield Unit ◽  
Type I ◽  
Hepatic Cysts ◽  
Hepatic Alveolar Echinococcosis ◽  
Type Iv ◽  
The Difference ◽  
The Individual

Background. Alveolar echinococcosis (AE) is a rare zoonosis caused by the larval stage of the tapeworm Echinococcus multilocularis. AE lesions affect the liver in more than 98% of cases. AE lesions have various morphological characteristics that are described in the Echinococcus multilocularis Ulm classification for computed tomography (EMUC-CT). One of these characteristics is a cystoid portion. The aim of the study was to compare the density of simple hepatic cysts with cystoid portions of AE lesions classified on the basis of the EMUC-CT. Results. Hounsfield Unit (HU) measurements of the cystoid portions of all EMUC-CT type I–IV AE lesions (n = 155) gave a mean of 21.8 ± 17.6, which was significantly different from that of 2.9 ± 4.5 for the simple hepatic cysts (p < 0.0001). The difference between each of the individual AE types and simple hepatic cysts was also significant. In addition, the HU values of the cystoid portions in types I, II and IIIa/b and simple cysts were each significantly different from type IV (p < 0.0001). The HU measurements in type IV presented by far the highest mean. Conclusions. The significantly higher density measured in the cystoid portions of hepatic AE lesions offers a good means of differentiation from simple hepatic cysts.

scholarly journals Deciphering the metabolic perturbation in hepatic alveolar echinococcosis: a 1H NMR-based metabolomics study

2018 ◽  
Author(s):  
Caigui Lin ◽  
Lingqiang Zhang ◽  
Zhiliang Wei ◽  
Kian-Kai Cheng ◽  
Guiping Shen ◽  
...  
Keyword(s):  
Amino Acids ◽  
Blood Serum ◽  
Echinococcus Multilocularis ◽  
Alveolar Echinococcosis ◽  
Early Stage ◽  
Urine Samples ◽  
H Nmr ◽  
Hepatic Alveolar Echinococcosis ◽  
Serum And Urine ◽  
Serum And Urine Samples

AbstractHepatic alveolar echinococcosis (HAE) is a chronic and potentially lethal parasitic disease. It is caused by growth of Echinococcus multilocularis larvae in liver. To date, early-stage diagnosis for the disease is not mature due to its long asymptomatic incubation period. In this study, a proton nuclear magnetic resonance (1H NMR) -based metabolomics approach was applied in conjunction with multivariate statistical analysis to investigate the altered metabolic profiles in blood serum and urine samples from HAE patients and to identify characteristic metabolic markers associated with HAE. The current results identified 21 distinctive metabolic difference between the HAE patients and healthy individuals, which can be associated with perturbations in energy metabolism, amino acid metabolism, oxidative stress, and neurotransmitter imbalance. In addition, the Fischer ratio, which is the molar ratio of branched-chain amino acids to aromatic amino acids was found significantly lower (p<0.001) in blood serum from HAE patients. The ratio, together with changes in other metabolic pathways may provide new insight into mechanistic understanding of HAE pathogenesis, and may be useful for early-stage HAE diagnosis.Author SummaryHepatic alveolar echinococcosis (HAE) is a life-threatening disease caused by Echinococcus multilocularis infection. The disease has a long asymptomatic early stage (5~15 years), which complicates effective diagnosis of early-stage HAE even with advanced imaging techniques. Metabolomics is an emerging analytical platform that comprises of analysis of all small molecule metabolites that are present within an organism. The applications of metabolomics method on HAE may help to reveal the molecular biology mechanisms of HAE. In the current study, we had used 1H NMR-based metabolomics technique to investigate blood serum and urine samples from HAE patients. Altered metabolic responses and characteristic differential metabolites for HAE were identified. The metabolic profiling of human biofluids provided valuable information for early-stage HAE diagnosis and for therapeutic interventions, without having to extract HAE vesicles from patients. By featuring global and comprehensive metabolic status, the metabolomics approach holds considerable promise as a noninvasive, dynamic, and effective tool for probing the underlying mechanism of HAE.

Surgical treatment of alveolar echinococcosis: a single centre experience and systematic review of the literature

2019 ◽  
Vol 98 (4) ◽  
pp. 167-173
Keyword(s):  
Case Report ◽  
Echinococcus Multilocularis ◽  
Alveolar Echinococcosis ◽  
Lymphatic System ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Safety Margin ◽  
Surgical Removal ◽  
Single Centre Experience ◽  
Therapeutic Procedures

Introduction: Alveolar echinococcosis (AE) is a zoonosis caused by Echinococcus multilocularis. AE is primarily localised in the liver. Echinococcus multilocularis imitates tumour-like behaviour. It can metastasise through blood or lymphatic system to distant organs. Echinococcosis often remains asymptomatic due to its long incubation period and indistinct symptoms. Clinical symptoms are determined by the parasite’s location. Diagnosis of echinococcosis is based on medical history, clinical symptoms, laboratory tests, serology results, imaging methods and final histology findings. Surgical removal of the cyst with a safety margin, followed by chemotherapy is the therapeutic method of choice. Case report: We present a case report of alveolar echinococcosis in a thirty-year-old female patient in whom we surgically removed multiple liver foci of alveolar echinococcosis. The disease recurred after two years and required another surgical intervention. Conclusions: Alveolar echinococcosis is a disease with a high potential for a complete cure provided that it is diagnosed early and that the recommended therapeutic procedures are strictly adhered to.

Hepatic Alveolar Echinococcosis in Cynomolgus Monkeys (Macaca fascicularis)

2004 ◽  
Vol 41 (3) ◽  
pp. 229-234 ◽  
Author(s):  
L. N. Bacciarini ◽  
B. Gottstein ◽  
O. Pagan ◽  
P. Rehmann ◽  
A. Gröne
Keyword(s):  
Macaca Fascicularis ◽  
Alveolar Echinococcosis ◽  
Cynomolgus Monkeys ◽  
Hepatic Alveolar Echinococcosis

scholarly journals Unique MRI findings for differentiation of an early stage of hepatic alveolar echinococcosis

2015 ◽  
Vol 2015 (feb19 1) ◽  
pp. bcr2014208123-bcr2014208123 ◽  
Author(s):  
T. Aoki ◽  
M. Hagiwara ◽  
H. Yabuki ◽  
A. Ito
Keyword(s):  
Alveolar Echinococcosis ◽  
Early Stage ◽  
Mri Findings ◽  
Hepatic Alveolar Echinococcosis
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