Showing papers on "Alveolar hydatid disease published in 1987"

Spontaneous death of Echinococcus multilocularis: cases diagnosed serologically (by Em2 ELISA) and clinical significance.

Abstract: Nine cases of asymptomatic alveolar hydatid disease (AHD) of the liver were diagnosed in 1985 among Eskimos from the endemic region of western Alaska. The patients were identified by screening with the enzyme-linked immunosorbent assay, using purified Echinococcus multilocularis antigen (Em2 ELISA). Five patients, and one diagnosed earlier (1979), were found to have lesions in which the larval E. multilocularis had died spontaneously at an early stage of infection. Viability was assessed histologically; by the avidinbiotin immunohistochemical method; and in vivo through intraperitoneal inoculation of membranes of the larval cestode into red-backed voles, Clethrionomys rutilus. The results were in agreement with the clinical impression, based on findings by computerized tomography and ultrasound scanning, and on the macroscopic appearance of the lesions, that the cestode was dead. Spontaneous death of E. multilocularis in humans has not been previously reported. The findings show that the Em2 ELISA may be positive in patients having lesions of AHD in which the etiologic agent is no longer viable.

Comparison of serologic tests for the diagnosis and follow-up of alveolar hydatid disease.

Abstract: Alveolar hydatid disease is a serious and often fatal condition caused by infection with the metacestode form of Echinococcus multilocularis. Sera of 21 patients with histologically confirmed disease were tested by an enzyme-linked immunosorbent assay (ELISA) using a semi-purified E. multilocularis antigen fraction (Em2) and by indirect hemagglutination (IHA) and double diffusion (DD5) tests using antigens prepared from E. granulosus cyst fluid. At diagnosis, sera from all 21 patients were positive by Em2 ELISA, 18 (86%) by IHA, and 5 (24%) by DD5. Em2 ELISA detected an antibody response earlier than IHA in 4 of 9 patients from whom sera were available before diagnosis. Following complete surgical resection, Em2 ELISA converted from positive to negative in serum of 2 of 3 patients, while IHA results did not change. Following incomplete resection, 14 of 15 patients tested remained positive by Em2 ELISA, while 12 remained positive by IHA. Of sera from 361 healthy persons from regions free of E. multilocularis, none were positive by Em2 ELISA, while 8% were positive by IHA. Of sera from 59 patients with non-echinococcal parasitic infections, none were positive by Em2 ELISA, while 31% were positive by IHA. Thus, in comparison with tests using E. granulosus antigens, Em2 ELISA appears to be more sensitive and specific for diagnosing AHD, useful on follow-up of resected patients, and positive earlier in the course of disease.

Albendazole therapy in alveolar hydatid disease: a report of favorable results in two patients after short-term therapy.

Abstract: Albendazole was administered preoperatively to two patients with active alveolar hydatid disease for 58 and 84 days. Vesicles of larval Echinococcus multilocularis obtained from surgical tissues were inoculated into red-backed voles for in vivo testing viability. No proliferation of the larval cestode had occurred when the animals were dissected three months post-inoculation. These findings suggest that short-term therapy with albendazole was effective in killing the larval cestode in these two cases. Albendazole was found to be hepatotoxic but resulting transaminase abnormalities have been reversible. Close monitoring of liver function and hematology is essential in patients under albendazole therapy.

Demonstration of amyloid and immune complex deposits in renal and hepatic parenchyma of Alaskan alveolar hydatid disease patients.

Abstract: Histopathological changes and the incidence of amyloid and immune complex (IC) deposits were examined in six liver (autopsy or biopsy) and two kidney (autopsy) samples from seven Alaskan alveolar hydatid disease (AHD) patients. Both the kidney samples showed evidence of severe nephropathy and glomerular IC deposits. Two of the six liver samples had typical amyloid deposits. All the liver samples examined showed variable amounts of parenchymal atrophy adjacent to the locus of larval Echinococcus multilocularis, periportal and portal fibrosis. Thus secondary amyloidosis and IC-mediated pathological changes should be included as possible complications of AHD.

Intraocular Echinococcus multilocularis

Abstract: • Alveolar hydatid disease, caused by the organism Echinococcus multilocularis , is a potentially lethal helminthic infection. After initial hepatic infestation, the organism may spread locally and hematogenously to distant sites. Death occurs secondary to hepatic failure, local extension into vital structures, or metastasis to the brain or lungs. A 67-year-old male Alaskan Eskimo developed decreased visual acuity secondary to a choroidal mass in the right eye eight years after an initial diagnosis of alveolar hydatid disease and four years before the development of symptomatic cerebral metastasis. A pathologic examination disclosed characteristic parasitic membranes involving the posterior pole of the right eye. To our knowledge, this is the first report of ocular involvement in alveolar hydatid disease.

Alveolar hydatid disease of the liver made by inoculation of scolices into the liver of cotton rat.

Abstract: 肝多包虫症の治療法の開発に役立つ実験モデルの作成を目的として,多包虫幼虫に感受性の高いCotton ratを用いて,腹腔内に継代移植している多包虫原頭節をサスペンジョンとして肝葉に接種した.肉眼的に接種8週後には5匹中4匹,10週後には4匹全例に肝に限局性のcystの形成を認めた.これは組織学的に完成した多包虫cystsであり,壁は2層よりなり,内面には繁殖胞が形成され,その内腔に多数の原頭節を認めた.この病巣は肝多包虫症の治療法の開発に有用と思われる.