Comparison of serological and clinical findings in Turkish patients with cystic echinococcosis

A. Yolasigmaz 1 , K. Reiterová 2 , M. Turk 3 , E. Reyhan 4 , A. Bozdag 4 , A. Karababa 5 , Nuray Altintas 6 , and Nasmiye Altintas 1
  • 1 School of Medicine, Department of Parasitology, Ege University, İzmir, Turkey
  • 2 Parasitological Institute of the Slovak Academy of Sciences, Košice, Slovak Republic
  • 3 Dept. of Microbiology, Atatürk Research and Training Hospital, İzmir, Turkey
  • 4 Dept. of General Surgery, Atatürk Research and Training Hospital, İzmir, Turkey
  • 5 School of Medicine, Dept. of Public Health, Ege University, İzmir, Turkey
  • 6 School of Medicine, Department of Medical Biology and Genetics, Celal Bayar University, Manisa, Turkey

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.

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