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Alveolar Hydatid Disease

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Bruno Gottstein – One of the best experts on this subject based on the ideXlab platform.

  • Epidemiology and systematics of cystic and Alveolar Hydatid Disease
    Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen, 2000
    Co-Authors: Bruno Gottstein

    Abstract:

    Echinococcus multilocularis, a small tapeworm in foxes, has gained considerable public attention owing to its wide distribution in central Europe. Conversely, diagnosis and treatment of the Disease have been significantly improved in recent years. Consequently, the incidence among human populations has remained stable and relatively low for many decades. In southern Germany, France (Franche Comte and Doubs), Austria and Switzerland, the annual incidence ranges between 0.02 and 1.4 new cases per 100,000 inhabitants. The relevance of human AE refers to the high lethality of the untreated Disease. Therapy consists predominantly of radical surgery followed by continuous, long-term chemotherapy using albendazole (or mebendazole). The action of chemotherapy alone is parasitostatic rather than parasitocidal; nevertheless, clinical improvement is observed in > 80 % of such cases, including a significantly improved prognosis. Diagnosis relies predominantly on imaging procedures and serology. Immunodiagnosis must be performed early, especially when a preclinical diagnosis is desired upon exposure to infection. Thus, in the framework of seroepidemiological studies, first-time evidence was obtained about the phenomenon of natural resistance in non-Diseased persons. This raised the question of a potential immunogenetic predisposition in certain infected persons. E. granulosus (cystic Hydatid Disease) is practically non-existent as autochthonous infection in central Europe now. Most clinical cases of E. granulosus infections are thus observed among persons who have immigrated from – predominantly – the mediterranean basin.

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  • Cytologic diagnosis of isolated pancreatic Alveolar Hydatid Disease with immunologic and PCR analyses : A case report
    Acta Cytologica, 1997
    Co-Authors: S Diebold-berger, H Khan, E Puget, J L Frossard, Bruno Gottstein, S Remadi

    Abstract:

    BACKGROUND

    Alveolar Hydatid Disease (AHD) is a rare and severe parasitic infection caused by the larval stage of the fox tapeworm, Echinococcus multilocularis. AHD mainly involves the liver, and although it may extend progressively to the pancreas, isolated pancreatic localization has not been reported previously.

    CASE

    A 68-year-old white female presented with a multicystic mass in the pancreas. Fine needle aspiration showed some protoscolices, free hooklets and fragments of laminated layer, which are pathognomonic features of echinococcosis. Serologic analyses by an enzyme-linked immunosorbent assay using Em2plus antigen showed high antibody reactivity of the patient’s serum, which is indicative of an infection with E multilocularis. Diagnosis was finally confirmed by molecular and immunologic analyses of the cytologic material by polymerase chain reaction and direct immunofluorescence.

    CONCLUSION

    This case illustrates the value of cytology in the identification of echinococcosis, particularly when it involves extrahepatic sites, where the risk of misdiagnosis may be related to its extremely rare occurrence. Precise parasitologic tying of E multilocularis in endemic areas is important.

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  • Immunological parameters associated with susceptibility or resistance to Alveolar Hydatid Disease in Yupiks/Inupiats.
    Arctic medical research, 1996
    Co-Authors: Bruno Gottstein, Florence Bettens, A J Parkinson, F Wilson

    Abstract:

    Alveolar Hydatid Disease (AHD) is a serious and often fatal Disease with a relatively high prevalence among the Alaska native Yupik/Inupiat population. In a few patients, however, a spontaneous cure of the Disease has been shown by demonstrating the presence of dead metacestode lesions. The present study shows a comparative analysis of the humoral (antibody activity to two different antigens: Em2-antigen and recombinant II/3-10-antigen) immune response and a respective immunogenetic background (HLA-DR typing) in (i) “susceptible” patients who had a still active intrahepatic metacestode and (ii) “resistant” patients who were shown to be spontaneously cured by presenting dead and calcified lesions. Control groups included relatives who were genetically closely related and less related cohabitants of the same villages. Antibody levels in the Em2- and the II/3-10-ELISA were high for patients who had still active lesions and low (Em2-ELISA) or negative (II/3-10-ELISA) for cured patients with dead lesions. Comparative HLA-DR analyses between infected and non-infected Yupiks/Inupiats revealed a slight tendency for susceptibility markers respective to the HLA-DRB1*0901 and HLA-DRB1*1601,02 genes.

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A F Petavy – One of the best experts on this subject based on the ideXlab platform.

  • Echinococcus multilocularis in domestic cats in France. A potential risk factor for Alveolar Hydatid Disease contamination in humans.
    Veterinary parasitology, 2000
    Co-Authors: A F Petavy, F Tenora, S Deblock, V Sergent

    Abstract:

    In France, in North of Alps and South of Jura, around the Swiss town of Geneva, the cestode E. multilocularis was found in three out of 81 domestic cats necropsied given by veterinarians. Morphological and morphometric features established the identity of this species. In an endemic area of Alveolar Hydatid Disease, the prevalence of E. multilocularis in the domestic cat confirms that it is a risk factor for human beings and mainly for veterinarians.

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  • Detection of antibodies against glycolipids of Echinococcus multilocularis metacestodes in sera of patients with Alveolar Hydatid Disease.
    Parasite immunology, 1991
    Co-Authors: Florence Persat, C. Vincent, Madeleine Mojon, A F Petavy

    Abstract:

    Glycosphingolipids extracted from Echinococcus multilocularis metacestodes were tested against sera from patients with Alveolar Hydatid Disease (AHD). The tests were performed first by ELISA then by immunostaining on thin layer chromatography. A binding between the parasite glycolipids and antibodies of AHD human sera was observed by ELISA. The glycolipids related to this binding were specifically parasite neutral glycosphingolipids. No reaction was observed with parasite acid glycolipids nor with neutral glycolipid extracts from human or mongolian gerbil erythrocytes. Comparison between absorbance values of 25 AHD sera and 20 control sera showed significant differences. Similar results were obtained with sera from Hydatid cyst patients. Sera from patients with other parasitoses (schistosomiasis, strongyloidosis or paludism) were also tested. The reactive fractions were identified by immunostaining on thin layer chromatography with AHD sera, they were neutral glycosphingolipids containing at least two carbohydrate residues. These results were compared with chromatograms obtained with Hydatid cyst human sera and discussed.

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  • Life cycles of Echinococcus multilocularis in relation to human infection.
    The Journal of parasitology, 1991
    Co-Authors: A F Petavy, S Deblock, S. Walbaum

    Abstract:

    The cycle of Echinococcus multilocularus in natural and synanthropic hosts was investigated during 10 yr in an endemic focus of Alveolar Hydatid Disease in the Massif Central of France. The natural cycle, involving red foxes, Vulpes vulpes, and voles, Arvicola terrestris, existed immediately surrounding a village in which human cases of Alveolar Hydatid Disease occurred. Both foxes and free-ranging dogs could serve as the source of infection for the human population.

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Mehdi Jabbari-nooghabi – One of the best experts on this subject based on the ideXlab platform.

  • Difficulties in the diagnosis and management of Alveolar Hydatid Disease: A case series.
    Caspian journal of internal medicine, 2016
    Co-Authors: Ghodratollah Maddah, Abbas Abdollahi, Alireza Tavassoli, Reza Sharifi-nooghabi, Mohammad Taghi Rajabi-mashadi, Azadeh Jabbari-nooghabi, Mehdi Jabbari-nooghabi

    Abstract:

    Larval Alveolar echinococcosis (AE) also known as Alveolar colloid of the liver, is caused by a rodent cestode (Echinococcus multilocularis). Alveolar Hydatid Disease is a less common Disease which is mostly seen in countries with larger reservoirs of hosts (foxes, dogs and wolves) such as Antarctica and Arctic region (1). Biological behavior of larval Echinococcus multilocularis in human is similar to a malignant tumor that is determined by growth of damaging tissues and metastasis to distant organs. The Disease has a high mortality rate (more than 90 % within 10 years and virtually 100 % within 15 years of the onset of symptoms) in untreated cases (2). This larva differs from E. granulosus in cystic echinococcosis of the liver. The growth and proliferation of this larva is similar to a slow-growing tumor of the liver and can damage liver function. Sometimes, it is difficult to differentiate it from liver cancer because of invasion to biliary and vascular tissue of the liver. Early diagnosis and radical surgery provide the best chance for definitive treatment and cure (3). Although treatment of AE is less effective than treatment of cystic echinococcus, still the general approach to its treatment remains to be surgery with the purpose of complete resection of infected parts of involved organs. Also, liver transplantation can be a lifesaving approach in patients who are at risk of death (4).

    According to our review of literature, Alveolar echinococcosis had been reported in Iran as sporadic, (5) but in the past two decades, we detected an endemic area in Chenaran (Khorasan Razavi, Iran) with a population of 108,533 in 26,937 families (6). The aim of this study was to describe the clinical aspects and treatment results in patients with Alveolar echinococcosis.

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