Rozpoznanie i leczenie bąblowicy wielojamowej – aktualny stan wiedzy oraz problemy w codziennej praktyce w Polsce
Małgorzata Sulima 1 , Katarzyna Sikorska 1 , Wacław Nahorski 1 , Sebastian Borys 1Abstrakt
The aim of the study is to summarize the current state of knowlege in the diagnosis and monitoring of patients with alveolar echinococcosis (AE), using serological tests and imaging techniques, and to present the most recent therapeutic guidelines based on a literature review. The paper discusses the challenges in diagnosing and treating AE encountered in clinical practice in Poland, based on the analysis of medical records of 86 patients with AE, who were hospitalized in the University Centre for Maritime and Tropical Medicine (UCMTM) between 2000 and 2018. In Poland, AE is usually diagnosed at the advanced stage, when optimal, radical surgery is not an option. Diagnosis of AE is often preceded by invasive diagnostic methods, such as biopsy or exploratory laparotomy, which may result in the infection spreading. Pharmacological treatment is associated with potential adverse effects and is a significant financial burden for the patient due to the lack of reimbursement. There is a need to raise the awareness of AE among physicians performing imaging studies and to facilitate access to modern techniques enabling the assessment of the parasitic process.
Przypisy
- 1. Aji T., Dong J.H., Shao Y.M., Zhao J.M., Li T., Tuxun T., ShalayiadangP., Ran B., Jiang T.M., Zhang R.Q., He Y.B., Huang J.F., Wen H.:Ex vivo liver resection and autotransplantation as alternative toallotransplantation for end-stage hepatic alveolar echinococcosis.J. Hepatol., 2018; 69: 1037–1046
Google Scholar - 2. Ambregna S., Koch S., Sulz M.C., Grüner B., Öztürk S., Chevaux J.B.,Sulima M., de Gottardi A., Napoléon B., Abergel A., Bichard P., BoytchevI., Deprez P., Dumortier J., Frossard J.L., et al.: A European surveyof perendoscopic treatment of biliary complications in patients withalveolar echinococcosis. Expert Rev. Anti Infect. Ther., 2017; 15: 79–88
Google Scholar - 3. Ammann R.W., Hoffmann A.F., Eckert J.: Swiss study of chemotherapyof alveolar echinococcosis-review of a 20-year clinical researchproject. Schweiz. Med. Wochenschr., 1999; 129: 323–232
Google Scholar - 4. Aydinli B., Ozturk G., Arslan S., Kantarci M., Tan O., Ahiska-liogluA., Özden K., Colak A.: Liver transplantation for alveolar echinococcosisin an endemic region. Liver Transpl., 2015; 21: 1096–1102
Google Scholar - 5. Azizi A., Blagosklonov O., Lounis A., Berthet L., Vuitton D.A., Bresson-Hadni S., Delabrousse E.: Alveolar echinococcosis: correlationbetween hepatic MRI findings and FDG-PET/CT metabolic activity.Abdom. Imaging., 2015; 40: 56–63
Google Scholar - 6. Balci N.C., Tunaci A., Semelka R.C., Tunaci M., Ozden I., RozanesI., Acunas B.: Hepatic alveolar echinococcosis: MRI findings. Magn.Reson. Imaging., 2000; 18: 537–541
Google Scholar - 7. Becce F., Pomoni A., Uldry E., Halkic N., Yan P., Meuli R., SchmidtS.: Alveolar echinococcosis of the liver: Diffusion-weighted MRI findingsand potential role in lesion characterisation. Eur. J. Radiol.,2014; 83: 625–631
Google Scholar - 8. Bresson-Hadni S., Blagosklonov O., Knapp J., Grenouillet F., SakoY., Delabrousse E., Brientini M.P., Richou C., Minello A., AntoninoA.T., Gillet M., Ito A., Mantion G.A., Vuitton D.A.: Should possible recurrenceof disease contraindicate liver transplantation in patientswith end-stage alveolar echinococcosis? A 20-year follow-up study.Liver Transpl., 2011; 17: 855–865
Google Scholar - 9. Bresson-Hadni S., Koch S., Miquet J.P., Gillet M., Mantion G.A.,Heyd B., Vuitton D.A.: European group of clinicians: Indications andresults of liver transplantation for Echinococcus alveolar infection:an overview. Langenbecks Arch. Surg., 2003; 388: 231–238
Google Scholar - 10. Bresson-Hadni S., Vuitton D.A., Bartholomot B., Heyd B., GodartD., Meyer J.P., Hrusovsky S., Becker M.C., Mantion G., Lenys D., MiguetJ.P.: A twenty-year history of alveolar echinococcosis: analysisof series of 117 patientsfrom eastern France. Eur. J. Gastroenterol.Hepatol., 2000; 12: 327–336
Google Scholar - 11. Brunetti E., Kern P., Vuitton D.A., Writing Panel for the WHO-IWGE.: Expert consensus for the diagnosis and treatment of cysticand alveolar echinococcosis in humans. Acta Trop., 2010; 114: 1–16
Google Scholar - 12. Bulakçi M., Kartal M.G., Yilmaz S., Yilmaz E., Yilmaz R., SahinD., Asik M., Erol O.B.: Multimodality imaging in diagnosis and managementof alveolar echinococcosis: an update. Diagn. Interv. Radiol.,2016; 22: 247–256
Google Scholar - 13. Chen K.F., Tang Y.Y., Wang R., Fang D., Chen J.H., Zeng Y., Li B.,Wen T.F., Wang W.T., Wu H., Xu M.Q., Yang J.Y., Wei Y.G., Huang J.W.,Li J.X., et al.: The choose of different surgical therapies of hepaticalveolar echinococcosis: A single-center retrospective case controlstudy. Medicine, 2018; 97: e0033
Google Scholar - 14. Conraths F.J., Probst C., Possenti A., Boufana B., Saulle R., La TorreG., Busani L., Casulli A.: Potential risk factors associated with human alveolar echinococcosis: Systematic review and meta-analysis. PLoSNegl. Trop. Dis., 2017; 11: e0005801
Google Scholar - 15. Coşkun A., Öztürk M., Karahan O.I., Erdogan N., Isin S., Güleç M.:Alveolar echinococcosis of the liver: Correlative color doppler US,CT, and MRI Study. Acta Radiol., 2004; 45: 492–498
Google Scholar - 16. Demirbas T., Akyildiz M., Dayangac M., Yaprak O., Dogusoy G.,Bassullu N., Yuzer Y., Tokat Y.: Living donor right lobe liver transplantationas a treatment for hepatic alveolar echinococcosis: reportof three cases. Hepatogastroenterology, 2015; 62: 93–97
Google Scholar - 17. Eckert J., Deplazes P.: Biological, epidemiological and clinicalaspects of echinococcosis, a zoonosis of increasing concern. Clin.Microbiol. Rev., 2004; 17: 107–135
Google Scholar - 18. Ehrhardt A.R., Reuter S., Buck A.K., Haenle M.M., Mason R.A.,Gabelmann A., Kern P., Kratzer W.: Assessment of disease activity inalveolar echinococcosis: comparison of contrast -enhanced ultrasound,tree-phase helical CT and [18F] fluorodeoxyglucose positron-emission tomography. Abdom. Imaging., 2007; 32: 730–736
Google Scholar - 19. Frei P., Misselwitz B., Prakash M.K., Schoepfer A.M., Prinz VavrickaB.M., Müllhaupt B., Fried M., Lehmann K., Ammann R.W.,Vavricka S.R.: Late biliary complications in human alveolar echinococcosisare associated with high mortality. World J. Gastroenterol.,2014; 20: 5881–5888
Google Scholar - 20. Fujimoto Y., Ito A., Ishikawa Y., Inoue M., Suzuki Y., Ohhira M.,Ohtake T., Kohgo Y.: Usefulness of recombinant Em18-ELISA to evaluateefficacy of treatment in patients with alveolar echinococcosis.J. Gastroenterol., 2005; 40: 426–431
Google Scholar - 21. Gao C.H., Wang J.Y., Shi F., Steverding D., Wang X., Yang Y.T.,Zhou X.N.: Field evaluation of an immunochromatographic test fordiagnosisof cystic and alveolar echinococcosis. Parasit. Vectors,2018; 11: 311
Google Scholar - 22. Gawor J.: Alveolar echinococcosis in Europe and Poland – Threatsto humans. Przegl. Epidemiol., 2016; 70: 281–288
Google Scholar - 23. Gottstein B., Jacquier P., Bresson-Hadni S., Eckert J.: Improvedprimary immunodiagnosis of alveolar echinococcosis in humans byan enzyme-linked immunosorbent assay using the Em2plus antigen.J. Clin. Microbiol., 1993; 31: 373–376
Google Scholar - 24. Graeter T., Ehing F., Oeztuerk S., Mason R.A., Haenle M.M.,Kratzer W.: Hepatobiliary complications of alveolar echinococcosis:Along-term follow-up study. World J. Gastroenterol., 2015; 21:4925–4932
Google Scholar - 25. Graeter T., Kratzer W., Oeztuerk S., Haenle M.M., Mason R.A.,Hillenbrand A., Kull T., Barth T.F., Kern P., Gruener B.: Proposal ofa computed tomography classification for hepatic alveolar echinococcosis.World J. Gastroenterol., 2016; 22: 3621-3631
Google Scholar - 26. Ishikawa Y., Sako Y., Itoh S., Ohtake T., Kohgo Y., Matsuno T., OhsakiY., Miyokawa N., Nakao M., Nakaya K., Ito A.: Serological monitoring ofprogression of alveolar echinococcosis with multiorgan involvementby use of recombinant Em18. J. Clin. Microbiol., 2009; 47: 3191–3196
Google Scholar - 27. Ito A., Ma L., Paul M., Stefaniak J., Pawlowski Z.: Evaluation ofEm18-, Em16-, antigen B-western blots, Em2plus ELISA and fourother tests for differential serodiagnosis of alveolar and cysticechinococcosispatients in Poland. Parasitol. Int., 1998; 47: 95–99
Google Scholar - 28. Ito A., Sako Y., Yamasaki H., Mamuti W., Nakaya K., Nakao M., IshikawaY.: Development of Em18-immunoblot and Em18-ELISA for specificdiagnosis of alveolar echinococcosis. Acta Tropica, 2003; 85: 173–182
Google Scholar - 29. Ito A., Xiao N., Liance M., Sato M.O., Sako Y., Mamuti W., IshikawaY., Nakao M., Yamasaki H., Nakaya K., Bardonnet K., Bresson-Hadni S.,Vuitton D.A.: Evaluation of an enzyme-linked immunosorbent assay(ELISA) with affinity-purified Em18 and an ELISA with recombinantEm18 for differential diagnosis of alveolar echinococcosis; results ofa blind test. J. Clin. Microbiol., 2002; 40: 4161–4165
Google Scholar - 30. Kern P., Bardonnet K., Renner E., Auer H., Pawlowski Z., AmmannR.W., Vuitton D.A., Kern P.: European echinococcosis registry:human alveolar echinococcosis, Europe, 1982-2000. Emerg. Infect.Dis., 2003; 9: 343–349
Google Scholar - 31. Knapp J., Sako Y., Grenouillet F., Bresson-Hadni S., Richou C., Gbaguidi-Haore H., Ito A., Millon L.: Comparison of the serological testsICT and ELISA for the diagnosis of alveolar echinococcosis in France.Parasite, 2014; 21: 34
Google Scholar - 32. Kodama Y., Fujita N., Shimizu T.: Alveolar echinococcosis: MRfindings in the liver. Radiology, 2003; 228: 172–177
Google Scholar - 33. Kratzer W., Gruener B., Kaltenbach T.E., Ansari-Bitzenberger S.,Kern P., Fuchs M., Mason R.A., Barth T.F., Haenle M.M., Hillenbrand.,Oeztuerk S., Graeter T.: Proposal of an ultrasonographic classificationfor hepatic alveolar echinococcosis: Echinococcosis multilocularisUlm classification-ultrasound. World J. Gastroenterol., 2015; 21:12392–12402
Google Scholar - 34. Kratzer W., Reuter S., Hirschbuehl K., Ehrhardt A.R., Mason R.A.,Haenle M.M., Kern P., Gabelmann A.: Comparison of contrast-enhancedpower Doppler ultrasound (Levovist) and computed tomographyin alveolar echinococcosis. Abdom. Imaging., 2005; 30: 286–290 35 Li T., Ito A., Chen X., Sako Y., Qiu J., Xiao N., Qiu D., Nakao M.,Yanagida T., Craig P.S.: Specific IgG responses to recombinant antigenB and Em18 in cystic and alveolar echinococcosis in China. Clin.Vaccine Immunol., 2010; 17: 470–475
Google Scholar - 35. years. J. Hepatol., 2008; 49: 72–77
Google Scholar - 36. Liance M., Janin V., Bresson-Hadni S., Vuitton D.A., Houin R., PiarrouxR.: Immunodiagnosis of Echinococcus infections; confirmatorytesting and species differentiation by a new commercial western blot.J. Clin. Microbiol., 2000; 38: 3718–3721
Google Scholar - 37. Liu W., Delabrousse E., Blagosklonov O., Wang J., Zeng H., Jiang Y.,Wang J., Qin Y., Vuitton D.A., Wen H.: Innovation in hepatic alveolarechinococcosis imaging: best use of old tools, and necessary evaluationof new ones. Parasite, 2014; 21: 74
Google Scholar - 38. McManus D.P., Zhang W., Li J., Bartley P.B.: Echinococcosis. Lancet,2003; 362: 1295-1304
Google Scholar - 39. Mihmanli M., Idiz U.O., Kaya C., Demir U., Bostanci O., OmerogluS., Bozkurt E.: Current status of diagnosis and treatment of hepaticechinococcosis. World J. Hepatol., 2016; 8: 1169–1181
Google Scholar - 40. Myjak P., Nahorski W., Pietkiewicz H., von Nickisch-Rosenegk M.,Stolarczyk J., Kacprzak E., Felczak-Korzybska I., Szostakowska B., LuciusR.: Molecular confirmation of human alveolar echinococcosis inPoland. Clin. Infect. Dis., 2003; 37: e121–e125
Google Scholar - 41. Nahorski W.L., Knap J.P., Pawłowski Z.S., Krawczyk M., PolańskiJ., Stefaniak J., Patkowski W., Szostakowska B., Pietkiewicz H.,Grzeszczuk A., Felczak-Korzybska I., Gołąb E., Wnukowska N., PaulM., Kacprzak E., Myjak P., et al.: Human alveolar echinococcosis inPoland: 1990-2011. PLoS Negl. Trop. Dis., 2013; 7: e1986
Google Scholar - 42. Patkowski W., Kotulski M., Remiszewski P., Grąt M., ZieniewiczK., Kobryń K., Najnigier B., Ziarkiewicz-Wróblewska B., Krawczyk M.:Alveococcosis of the liver-strategy of surgical treatment with specialfocus on liver transplantation. Transpl. Infect. Dis., 2016; 18: 661–666
Google Scholar - 43. Qu B., Guo L., Sheng G., Yu F., Chen G., Wang Y., Shi Y., Zhan H.,Yang Y., Du X.: Management of advanced hepatic alveolar echinococcosis:Report of 42 cases. Am. J. Trop. Med. Hyg., 2017; 96: 680-685
Google Scholar - 44. Reuter S., Buck A., Manfras B., Kratzer W., Seitz H.M., Darge K.,Reske S.N., Kern P.: Structured treatment interruption in patientswith alveolar echinococcosis. Hepatology, 2004; 39: 509–517
Google Scholar - 45. Reuter S., Nüssle K., Kolokythas O., Haug U., Rieber A., Kern P.,Kratzer W.: Alveolar liver echinococcosis: A comparative study ofthree imaging techniques. Infection, 2001; 29: 119–125
Google Scholar - 46. Siles-Lucas M., Casulli A., Cirilli R., Carmena D.: Progress in thepharmacological treatment of human cystic and alveolar echinococcosis:Compounds and therapeutic targets. PLoS Negl.Trop. Dis.,2018; 12: e0006422
Google Scholar - 47. Stumpe K.D.M., Renner-Schneiter E.C., Kuenzle A.K., Grimm F.,Kadry Z., Clavien P.A., Deplazes P, von Schulthess G.K., Muellhaupt B.,Ammann R.W., Renner E.L.: F-18-fluorodeoxyglucose (FDG) positronemissiontomography of Echinococcus multilocularis liver lesions:prospective evaluation of its value for diagnosis and follow-up duringbenzimidazole therapy. Infection, 2007; 35: 11–18
Google Scholar - 48. Tiao-Ying L., Jia-Min Q., Craig P.S., Ito A., Wen Y., Vuitton D.A.,Ning X., Xingwang C., Wen Y., Schantz P.M.: Review of 311 cases ofalveolar echinococcosis and criteria for classification of hepaticultrasound images. Southeast Asian J. Trop. Med. Public Health,2004; 35: 213–217
Google Scholar - 49. Torgerson P.R., Schweiger A., Deplazes P., Pohar M., Reichen J.,Ammann R.W., Tarr P.E., Halkik N., Müllhaupt B.: Alveolar echinococcosis:From a deadly disease to a well-controlled infection. Relativesurvival and economic analysis in Switzerland over the last
Google Scholar - 50. Vuitton D.A., Zhou H., Bresson-Hadni S., Wang Q., PiarrouxM., Raoul F., Giraudoux P.: Epidemiology of alveolar echinococcosiswith particular reference to China and Europe. Parasitology, 2003;127(S1): 87–107
Google Scholar