Diagnostics in cystic echinococcosis: Serology versus ultrasonography

Background/Aims: Cystic echinococcosis (CE) is the most widespread zoonosis worldwide. The objective of the present study was to compare diagnostic methods in the work-up of suspected cystic echinococcosis of the liver.Materials and Methods: Data from a total of 68 patients were compiled and analyzed.Results: A diagnosis of cystic echinococcosis was made in 36.8% of patients. Broken down according to WHO criteria, patients with at least one echinococcus cyst were determined in 12.0% of cases to exhibit cysts consistent with stage 1 disease (CE1), while in 24.0%, cysts consistent with CE2 and CE3 were identified. CE4 and CE5 cysts were identified in 32.0% and 8.0% of patients, respectively. Solitary cysts were found in 60.0% of patients with cystic echinococcosis, while in patients with at least one cystic lesion, there were most often multiple cysts. The indirect hemagglutination test (IHA) and echinococcus-specific immunoglobulin E (IgE) concentration showed a higher sensitivity (60.9%, 68.4%) than did the enzyme-linked immunosorbent assay (ELISA) for Echinococcus multilocularis (Em2+) and total IgE (11.1%, 38.9%). The respective specificities of all four serological methods lay between 83.9% and 88.9%.Conclusion: Our data show that ultrasound remains the diagnostic method of choice in the work-up of cystic lesions of the liver suspected to be due to Echinococcus granulosus. Serological methods can serve an adjunctive role

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. WHO. Cystic Echinococcosis and Multilocular Echinococcosis. Available from: http://www.who.int/zoonoses/diseases/echinococcosis/en/index.html.
2. Grosso G, Gruttadauria S, Biondi A, Marventano S, Mistretta A. Worldwide epidemiology of liver hydatidosis including the Mediterranean area. World J Gastroenterol 2012; 18: 1425-37. [CrossRef]
3. Barnes TS, Deplazes P, Gottstein B, et al. Challenges for diagnosis and control of cystic hydatid disease. Acta Trop 2012; 123: 1-7. [CrossRef]
4. Mandal S, Mandal MD. Human cystic echinococcosis: Epidemiologic, zoonotic, clinical, diagnostic and therapeutic aspects. Asian Pac J Trop Med 2012; 5: 253-60. [CrossRef]
5. Ernest E, Nonga HE, Kynsieri N, Cleaveland S. A retrospective survey of human hydatidosis based on hospital records during the period 1990-2003 in Ngorongoro, Tanzania. Zoonoses Public Health 2010; 5: 124-9. [CrossRef]
6. Derfoufi O, Ngoh Akwa E, Elmaataoui A, et al. Epidemiological profile of cystic echinococcosis in Morocco from 1980 to 2008. Ann Biol Clin (Paris) 2012; 170: 457-61.
7. Vahedi MA, Vahedi ML. Demographics of patients with surgical and nonsurgical cystic echinococcosis in East Azerbaijan from 2001 to 2012. Pak J Biol Sci 2012; 15: 186-91. [CrossRef]
8. Eckert J, Deplazes P. Biological, epidemiological, and clinical aspects of echinococcosis, a zoonosis of increasing concern. Clin Microbiol Rev 2004; 17: 107-35. [CrossRef]
9. Mastrandrea S, Stegel G, Piseddu T, Ledda S, Masala G. A retrospective study on burden of human echinococcosis based on hospital discharge records from 2001 to 2009 in Sardinia, Italy. Acta Trop 2012; 123: 184-9. [CrossRef]
10. Stojkovic M, Rosenberger K, Kauczor HU, Junghanss T, Hosch W. Diagnosing and staging of cystic echinococcosis: How do CT and MRI perform in comparison to ultrasound? PLoS Negl Trop Dis 2012; 6: e1880.
11. Schweiger A, Grimm F, Tanner I, et al. Serological diagnosis of echinococcosis: the diagnostic potential of native antigens. Infection 2012; 40: 139-52. [CrossRef]
12. Nunnari G, Pinzone MR, Gruttadauria S, et al. Hepatic echinococcosis: Clinical and therapeutic aspects. World J Gastroenterol 2012; 18: 1448-58. [CrossRef]
13. WHO Informal Working Group. International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Trop 2003; 85: 253-61. [CrossRef]
14. Brunetti E, Gulizia R, Garlaschelli AL, et al. Cystic echinococcosis of the liver associated with repeated international travels to endemic areas. J Travel Med 2005; 12: 225-8 [CrossRef]
15. Taylor BR, Langer B. Current surgical management of hepatic cyst disease. Adv Surg 1997; 31: 127-48.
16. Cowles RA, Mulholland MW. Solitary hepatic cysts. J Am Coll Surg 2000; 191: 311-21. [CrossRef]
17. Brunetti E, Kern P, Vuitton DA; Writing Panel for the WHO-IWGE. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop 2010; 114: 1-16. [CrossRef]
18. Tabain I, Sviben M, Ljubin-Sternak S, Vilibić-Čavlek T, Mlinarić- Galinović G. Seroprevalence of Echinococcus granulosus infection in Croatian patients with cystic liver disease. J Helminthol 2010; 25: 1-4.
19. Macpherson CN, Milner R. Performance characteristics and quality control of community based ultrasound surveys for cystic and alveolar echinococcosis. Acta Trop 2003; 85: 203-9. [CrossRef]
20. Larssen TB, Rørvik J, Hoff SR, Horn A, Rosendahl K. The occurrence of asymptomatic and symptomatic simple hepatic cysts. A prospective, hospital-based study. Clin Radiol 2005; 60: 1026-9. [CrossRef]
21. Liang P, Cao B, Wang Y, Yu X, Yu D, Dong B. Differential diagnosis of hepatic cystic lesions with gray-scale and color doppler sonography. J Clin Ultrasound 2005; 33: 100-5. [CrossRef]
22. Kilimcioğlu AA, Ozkol M, Bayindir P, Girginkardeşler N, Ostan I, Ok UZ. The value of ultrasonography alone in screening surveys of cystic echinococcosis in children in Turkey. Parasitol Int 2006; 55: 273-5. [CrossRef]
23. Sarkari B, Sadjjadi SM, Beheshtian MM, Aghaee M, Sedaghat F. Human cystic echinococcosis in Yasuj District in southwest of Iran: an epidemiological study of seroprevalence and surgical cases over a ten-year period. Zoonoses Public Health 2010; 57: 146-50. [CrossRef]
24. Akyildiz HY, Akcan A, Karahan I, et al. Recurrent liver hydatid disease: When does it become symptomatic and how does one diagnose it? Clin Imaging 2009; 33: 55-8. [CrossRef]
25. Caremani M, Vincenti A, Benci A, Sassoli S, Tacconi D. Ecographic eidemiology of non-parasitic hepatic cysts. J Clin Ultrasound 1993: 21; 115-8. [CrossRef]
26. Zhang W, Li J, McManus DP. Concepts in immunology and diagnosis of hydatid disease. Clin Microbiol Rev 2003; 16: 18-36. [CrossRef]
27. Rogan MT, Hai WY, Richardson R, Zeyhle E, Craig PS. Hydatid Cysts: Does every picture tell a story? Trends Parasithol 2006; 22: 431-8. [CrossRef]
28. Czermak BV, Akhan O, Hiemetzberger R, et al. Echinococcosis of the liver. Abdom Imaging 2008; 33: 133-43. [CrossRef]
29. Eckert J, Gemmel MA, Meslin FX, et al. WHO/OIE Manual on echinococcosis in humans and animals: A public health problem of global concern. World Organization for Animal Health (OIE), Paris, France 2001.
30. McManus DP, Zhang W, Li J, et al. Echinococcosis. Lancet 2003; 362: 1295-304. [CrossRef]
31. Carmena D, Benito A, Eraso E. Antigens for the Immundiagnosis of Echinococcus granulosus infection: An update. Acta Trop 2006; 98: 74-86. [CrossRef]
32. Gavidia CM, Gonzales AE, Zhang W, et al. Diagnosis of cystic echinococcosis, central Peruvian Highlands. Emerg Infect Dis 2008; 14: 260-6. [CrossRef]
33. Nepalia S, Joshi A, Shende A, Sharma SS. Management of echinococcosis. J Assoc Physicians India 2006; 54: 458-62.
34. Scherer K, Gupta N, Caine WP, Panda M. Differential diagnosis and management of a recurrent hepatic cyst: A case report and review of literature. J Gen Intern Med 2009; 24: 1161-5. [CrossRef]
35. Gonlugur U, Ozcelik S, Gonlugur TE, et al. The retrospective annual surgical incidence of cystic echinococcosis in Sivas, Turkey. Zoonoses Public Health 2009; 56: 209-14. [CrossRef]
36. Mzali R, Ben Amar M, Kallel W, Kolsi K, Beyrouti MI, Ayadi A. Liver cystic echinococcosis: Which cysts are correlated with false negative indirect passive hemagglutination (IHA)? Tunis Med 2007; 85: 367-70.
37. Legatt GR, Yang W, McManus DP. Serological evaluation of the 12 kDa subunit of antigen B in Echinococcus granulosus cyst fluid by immunoblot analysis. Trans R Soc Trop Med Hyg 1992; 86: 189-92. [CrossRef]
38. Harandi MF, Moazezi SS, Saba M, et al. Sonographical and serological survey of human cystic echinococcosis and analysis of risk factors associated with seroconversion in rural communities of Kerman, Iran. Zoonoses Public Health 2011; 58: 582-8. [CrossRef]
39. Manzano-Román R, Siles-Lucas M. MicroRNAs in parasitic diseases: Potential for diagnosis and targeting. Mol Biochem Parasitol 2012; 186: 81-6. [CrossRef]

APA	WUESTENBERG J, GRUENER B, OEZTUERK S, MASON R, HAENLE M, GRAETER T, AKİNLİ A, KERN P, KRATZER W (2014). Diagnostics in cystic echinococcosis: Serology versus ultrasonography. , 398 - 404.
Chicago	WUESTENBERG Johanna,GRUENER Beate,OEZTUERK Suemeyra,MASON Richard A,HAENLE Mark M,GRAETER Tilmann,AKİNLİ Atilla S,KERN Peter,KRATZER Wolfgang Diagnostics in cystic echinococcosis: Serology versus ultrasonography. (2014): 398 - 404.
MLA	WUESTENBERG Johanna,GRUENER Beate,OEZTUERK Suemeyra,MASON Richard A,HAENLE Mark M,GRAETER Tilmann,AKİNLİ Atilla S,KERN Peter,KRATZER Wolfgang Diagnostics in cystic echinococcosis: Serology versus ultrasonography. , 2014, ss.398 - 404.
AMA	WUESTENBERG J,GRUENER B,OEZTUERK S,MASON R,HAENLE M,GRAETER T,AKİNLİ A,KERN P,KRATZER W Diagnostics in cystic echinococcosis: Serology versus ultrasonography. . 2014; 398 - 404.
Vancouver	WUESTENBERG J,GRUENER B,OEZTUERK S,MASON R,HAENLE M,GRAETER T,AKİNLİ A,KERN P,KRATZER W Diagnostics in cystic echinococcosis: Serology versus ultrasonography. . 2014; 398 - 404.
IEEE	WUESTENBERG J,GRUENER B,OEZTUERK S,MASON R,HAENLE M,GRAETER T,AKİNLİ A,KERN P,KRATZER W "Diagnostics in cystic echinococcosis: Serology versus ultrasonography." , ss.398 - 404, 2014.
ISNAD	WUESTENBERG, Johanna vd. "Diagnostics in cystic echinococcosis: Serology versus ultrasonography". (2014), 398-404.

APA	WUESTENBERG J, GRUENER B, OEZTUERK S, MASON R, HAENLE M, GRAETER T, AKİNLİ A, KERN P, KRATZER W (2014). Diagnostics in cystic echinococcosis: Serology versus ultrasonography. Turkish Journal of Gastroenterology, 25(4), 398 - 404.
Chicago	WUESTENBERG Johanna,GRUENER Beate,OEZTUERK Suemeyra,MASON Richard A,HAENLE Mark M,GRAETER Tilmann,AKİNLİ Atilla S,KERN Peter,KRATZER Wolfgang Diagnostics in cystic echinococcosis: Serology versus ultrasonography. Turkish Journal of Gastroenterology 25, no.4 (2014): 398 - 404.
MLA	WUESTENBERG Johanna,GRUENER Beate,OEZTUERK Suemeyra,MASON Richard A,HAENLE Mark M,GRAETER Tilmann,AKİNLİ Atilla S,KERN Peter,KRATZER Wolfgang Diagnostics in cystic echinococcosis: Serology versus ultrasonography. Turkish Journal of Gastroenterology, vol.25, no.4, 2014, ss.398 - 404.
AMA	WUESTENBERG J,GRUENER B,OEZTUERK S,MASON R,HAENLE M,GRAETER T,AKİNLİ A,KERN P,KRATZER W Diagnostics in cystic echinococcosis: Serology versus ultrasonography. Turkish Journal of Gastroenterology. 2014; 25(4): 398 - 404.
Vancouver	WUESTENBERG J,GRUENER B,OEZTUERK S,MASON R,HAENLE M,GRAETER T,AKİNLİ A,KERN P,KRATZER W Diagnostics in cystic echinococcosis: Serology versus ultrasonography. Turkish Journal of Gastroenterology. 2014; 25(4): 398 - 404.
IEEE	WUESTENBERG J,GRUENER B,OEZTUERK S,MASON R,HAENLE M,GRAETER T,AKİNLİ A,KERN P,KRATZER W "Diagnostics in cystic echinococcosis: Serology versus ultrasonography." Turkish Journal of Gastroenterology, 25, ss.398 - 404, 2014.
ISNAD	WUESTENBERG, Johanna vd. "Diagnostics in cystic echinococcosis: Serology versus ultrasonography". Turkish Journal of Gastroenterology 25/4 (2014), 398-404.