Leone N, Baronio M, Todros L, David E, Brunello F, Artioli S, Rizzetto M
Department of Gastroenterology, Azienda Ospedaliera S. Giovanni Battista, Turin, Italy.
Dig Liver Dis. 2006 Jul;38(7):511-4. doi: 10.1016/j.dld.2005.07.007. Epub 2005 Sep 15.
Patients with the clinical syndrome of visceral larva migrans as a result of Toxocara species, have typical lesions in the liver consisting of granulomas that contain numerous eosinophils and often Charcot-Leyden crystals. This syndrome is rarely taken into account in patients with cholestatic syndrome, especially when hypereosinophilic reaction is absent. We report the case of a 47-year-old immunocompetent woman who presented with abdominal pain, in whom multiple focal liver lesions were discovered. She had come in contact with dogs. Diagnosis of toxocariasi was done. A good clinical response has been obtained by treating with thiabendazole. We present the findings of various imaging studies of the patient. This report shows that visceral larva migrans may be the cause of a chronic liver disease and should be suspected also in patients without fever and hypereosinophilia with cryptogenic cholestatic and focal liver lesions.
因弓蛔虫属导致内脏幼虫移行临床综合征的患者，肝脏有典型病变，表现为含有大量嗜酸性粒细胞且常伴有夏科-雷登结晶的肉芽肿。胆汁淤积综合征患者很少考虑到这种综合征，尤其是在没有嗜酸性粒细胞增多反应时。我们报告一例47岁免疫功能正常的女性，她因腹痛就诊，发现肝脏有多处局灶性病变。她曾接触过狗。诊断为弓蛔虫病。使用噻苯达唑治疗后获得了良好的临床反应。我们展示了该患者各种影像学检查的结果。本报告表明，内脏幼虫移行可能是慢性肝病的病因，对于无发热、无嗜酸性粒细胞增多且病因不明的胆汁淤积和肝脏局灶性病变患者也应怀疑此病。
