Naslov
Progressive course of alveolar echinococcosis in an immunocompromised patient treated with infliximab.

Autori
Pavicic Ivelja, Mirela ; Petric, Marin ; Perkovic, Dijana ; Beck, Relja

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
Swiss Medical Weekly 2022 ; 152 (Suppl. 262) / - , 2022, 36-36

Skup
Annual Congress of the Swiss Society for Allergology and Immunology (SSAI) ; 22nd Symposium of the International Immunocompromised Host Society (ICHS)

Mjesto i datum
Basel, Švicarska, 08.09.2022. - 11.09.2022

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
immunocompromised ; alveolar echinococcosis ; monoclonal antibody ;

Sažetak
Background: Human alveolar echinococcosis (AE) is a zoonosis caused by the larval forms of Echinococcus multilocularis tapeworms with potentially increasing importance among immunocompromised patients. Case presentation: A 70-year-old male diagnosed with rheumatoid arthritis in 2008 was initially treated with prednisone, methotrexate, leflunomide, etanercept, and since 2014 with anti- TNF agent infliximab. Abdominal MSCT was performed due to a pathologically changed liver findings on the regular ultrasound verifying an inhomogeneous formation of the right lobe (16 x 6.8 cm) with the additional change of the I liver segment, a necrotic infiltrate preaortally, 7 x 5 cm, affecting the celiac trunk and right adrenal gland ; differential diagnosticly cholangiocarcinoma. The ultrasound findings 4 years earlier were described as normal. Liver punctate cytology showed tiny scolex hooks, which raised the suspicion of echinococcal disease, additionally confirmed by positive serology (IHA). PCR was successfully used for the amplification of E. multilocularis specific DNA fragments in tissue biopsy. Although antiparasitic therapy was started, the effect of albendazole is expectedly lower in AE and surgery is necessary. Due to the significant extension of AE and the impossibility of radical resection, liver transplantation is indicated. Conclusion: The presented case suggests the need of high clinical suspicion, early diagnosis and treatment of emergent parasitic infections, manifesting a particularly severe clinical features in a growing number of immunocompromised patients.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti, Veterinarska medicina

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