[Role of adhesion molecules in a determination of progression stages and clinical prognosis of patients with Echinococcus multilocularis]

ArticleinWiadomości parazytologiczne 50(3):483-9 · February 2004with4 Reads
Source: PubMed
Alveococcosis in humans is characterized by a tumor-like growth with a tendency to infiltration of neighbouring organs or metastases formation in the lungs and brain. The study aimed to improve on the clinical evaluation of patients with alveolar echinococcosis (AE) and to determine the risk of metacestode spreading to adjacent tissues or distant organs by a detection of adhesion molecules involved in the tumorigenesis process. Serum concentrations of sPECAM-1, sVCAM-1 and sE-selectin adhesion molecules were studied in 8 AE patients in comparison to 75 cases with malignant neoplasms, including cases with tumors of hepatic and extra-hepatic location. The adhesion molecules were found to be early predictive markers of the active, tissue infiltrated alveococcosis with the risk of parasite spreading through the circulation. High serum levels of soluble PECAM-1 molecule were strongly related to the advanced, progressive disease and the fatality of patients' clinical prognosis.
    • "In DTP MUG [24], DCTPD UMP [26] and DP NIH [40] a routine serological diagnosis of AE based on 3 commercial tests was introduced in the nineties, and since 2000 molecular diagnosis of AE has been employed in DTP MUG [24]. The Poznan´ClinicalPoznan´ Poznan´Clinical (DCTPD UMP) instituted the serological studies involving the adhesive particles aimed at evaluating the clinical course and the degree of advancement of alveolar echinococcosis of the liver in humans [41]. However it should be taken into consideration that there is no unique 'gold standard' in diagnosis of AE, only a combination of clinical trials, imaging and laboratory diagnostic techniques can allow to diagnose a confirmed, probable or possible invasion. "
    [Show abstract] [Hide abstract] ABSTRACT: Alveolar echinococcosis (AE) caused by Echinococcus multilocularis infections is a dangerous old disease in the Northern Hemisphere. The aim of the paper was to collect and analyze data on human AE in Poland in the last two decades. The sources of data were both the cases officially registered and detected by an active field and laboratory surveillance. The cases were verified by clinical, epidemiological, and laboratory criteria. Altogether 121 human cases of AE were detected. Among these 83 (68,6%) cases were classified as confirmed, 16 as probable and 22 as possible. During the two decades a continuous increase in detection rate was noticed. The cases were 6-82 years old at the time of diagnosis (mean - 47.7 years). Sex ratio M/F was 0.86/1.0. The AE was fatal in 23 (19%) patients (mean age at death - 54.1 years). Family agglomeration of AE was found in 4 foci, involving 9 patients. Seventy six of the cases were diagnosed in an advanced stage of disease. In all cases the liver was the primary location of AE. In 30 (24.8%) patients a spread to other organs was observed. Ninety four of the patients were treated with albendazole. In 73 (60%) patients a surgical operation was performed, including 15 liver transplantations. The studies confirmed that AE is an emerging disease in Poland, which is the fourth country in Europe with over 120 cases detected. The results also indicate the need of a wider national programme for implementation of screening in the highest AE risk areas (north-eastern Poland) with an effort to increase the public awareness of the possibility of contracting E. multilocularis, and above all, training of the primary care physicians in the recognition of the risk of AE to allow for an early detection of this dangerous disease.
    Full-text · Article · Jan 2013
  • [Show abstract] [Hide abstract] ABSTRACT: Objective. Echinococcosis is a rather seldom detected parasitic disease affecting the CNS in 2% of cases only. Diagnostic difficulties occur if presentations in neuroimaging assessment are atypical, as in this disease serological tests can be negative for a long time since the onset of clinical symptoms. Cases. Two patients with echinococcosis are described: a 53-year-old man with an isolated cerebral form of echinococcosis and an atypical brain MRI scan showing disseminated focal lesions, and a woman aged 18, with an ophtalmic form of the disease and disseminated neurological signs. Commentary. Echinococcosis continues to be seen in Poland. Isolated intracerebral forms of this disease are very rare. The diagnosis should be based on neuroimaging findings, as well as serological test results and cerebrospinal fluid analysis. Oral treatment is an alternative method in non-operative cases.
    Article · Jan 2008
  • [Show abstract] [Hide abstract] ABSTRACT: Background: Alveoccosis is one out of four plagues of the 21st century. In some cases diagnosis is very difficult. Case Raport: Patient JP, 52 yo male, wildlife handler was admitted to our hospital in 2006 because of disseminated disease of unknown etiology which was located in the retroperitoneal space, pericardium, liver, diaphragm, IVC, both lungs, pelvis and the stump of his right hip. In the past, he has been hospitalized in many orthopedic, surgical and tropical medicine departments because of the history of the stabbed wound of the right hip with phlegmon of the right thigh. Previously, a patient has been diagnosed to have TB which had been treated with the first-line drugs for a year with no clinical improvement. In 1999 he had undergone amputation of the right leg above the knee due to the osteitis and inability to drain a collection of a pus followed by lymphadenectomy of the inguinal nodes which revealed Histoplasmosis. The patient had been treated with ketokonazol for a year and which caused a 6 years remission of symptoms. In 2005, a progression of a disease had been observed and because of phlegmon in retroperitoneal space with a mass in right kidney and suprarenal gland the patient had right nephrectomy. In 2006 because of the progression of a disease, patient was admitted to our hospital. Patient underwent multiple operations including liver resection (seg. 8) venocavothomy, partial cystectomy of the pericardium followed by removal of the mass infiltrating the right psoas muscle and right pelvis. Immunological diagnosis by using a reference Western-blot technique has finally confirmed infection with Echinococcus multilocularis. Now, the patient is stabile and followed-up on a long-term chemotherapy with albendazol. Conclusions: Alveococcosis should be considered in differential diagnosis of every cystic mass in every anatomic location, especially when these occur in areas where the disease is endemic. Diagnosis and treatment requires multidisciplinary approach.
    Article · Dec 2008 · Postepy Psychiatrii i Neurologii
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