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  • Author: Altintas Nuray x
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Abstract

Cystic echinococcosis (CE) due to Echinococcus granulosus is one of the most important helminthic diseases in Turkey where it constitutes a public health and economic problems. Its mean annual incidence in humans is 4.4/100 000 and the prevalence of the tapeworm agent in domestic animals ranges from 11.2 to 50.7 %. Since 1980s, albendazole has been used for treatment of the disease, and this benzimidazole drug has been considered to be of relatively low toxicity. However, prolonged albendazole therapy of CE became to be a common practice, and data on possible genotoxic effects of the medication in humans are lacking. This study has concerned 17 women and 11 men, in total 28 patients with liver cystic hydatid complaints, who were administered albendazole (15 mg/kg) preoperatively (2 weeks) and postoperatively (6 months). Genotoxic effects of albendazole were searched using Sister Chromatid Exchange (SCE), mitotic index (MI) and chromosomal aberations (CAs) methods, comparing lymphocyte chromosomes of treated patients and a control group of healthy individuals. The results indicated a significant increase of SCE frequencies and decrease of MI in the treated group (p < 0.001). Regarding CAs, any difference between the groups was not determined.

Abstract

Cystic echinococcosis (CE), caused by the cestode Echinococcus granulosus, is potentially dangerous for humans. The aim of this study was to examine serological and clinical findings regarding cysts localisation and individual responses in 54 patients with CE. The majority of patients in this study were females (63 %) and the average age was 46.3 years. Most of the patients lived in rural areas or kept a dog (46 %) for a long time. The most frequent symptoms were hypochondrial pain (48.9 %), epigastrial discomfort (27.7 %), vomiting (21.3 %), minor cough (12.8 %), urticaria (6.3 %), weakness (4.3 %), fever (2.1 %), side-or back-ache (4.3 %). However, 17 % of the patients showed no symptoms. In every case, the ultrasound (USG) and/or computer tomography (CT) investigations were positive. In most cases (53.2 % of the patients) a single cyst was found but 46.8 % of the patients had multiple cyst formations (from 2 to 9 cysts) located in the liver. Sporadic lung, splenetic, mesenterial, tibial and cerebral localisations were also found. The patients were individually treated with albendazol (10–15 mg/kg) five days prior and six months after the surgical treatment. Serum samples were investigated by the serological techniques: IHAT, ELISA and Western blot using hydatid fluid antigen. In the patient sera, the specific antibody levels were mostly increased after surgery. Different results were obtained only in two patients. In the first case, seroconversion was delayed. In the other case all ELISA results were negative, however, the Western blot analysis and surgery proved the presence of CE. The results suggest that the different antibody response of patients depends on the individual immune response. Multiple localization and various stages of CE cysts demonstrate the necessity of a complex approach for the confirmation of a correct diagnosis.