Department of Urology, First Affiliated Hospital of Xin Jiang Medical University, Urumqi, XinJiang, China.
PLoS One. 2012;7(11):e47667. doi: 10.1371/journal.pone.0047667. Epub 2012 Nov 2.
Human cystic echinococcosis (CE) is caused by flatworm larvae of Echinococcus granulosus and is endemic in many parts of the world. In humans, CE cysts primarily affect the liver and pulmonary system, but can also affect the renal system. However, the clinical manifestations of renal CE can be subtle, so healthcare professionals often overlook renal CE in differential diagnosis. In this study, we examined the clinical and demographic characteristics of patients with urinary tract CE and analyzed the diagnosis and treatment procedures for this disease.
The records of 19 consecutive renal CE patients who were admitted to the First Affiliated Hospital of Xinjiang Medical University from January 1983 to April 2011 were retrospectively reviewed. In all cases, CE of the urinary tract was confirmed by pathological examination and visual inspection during surgery.
Fifteen patients were males and 4 were females. The most common symptoms were non-specific lower back pain and percussion tenderness on the kidney region. All patients were followed up for 9-180 months after surgery. None of the patients experienced a recurrence of renal CE, but 4 patients experienced non-renal recurrence of hydatid disease.
Hydatid cysts from E. granulosus are structurally similar in the liver and urinary tract. Thus, the treatment regimen for liver CE developed by the World Health Organization/Informal Working Group on Echinococcosis (WHO/IWGE) could also be used for urinary tract CE. In our patients, the use of ultrasound, computed tomography, serology, and clinical characteristics provided a diagnostic accuracy of 66.7% to 92.3%.
人类包虫病(CE)是由细粒棘球绦虫幼虫引起的,在世界许多地区流行。在人类中,CE 囊肿主要影响肝脏和肺部系统,但也可能影响肾脏系统。然而,肾脏 CE 的临床表现可能很微妙,因此医疗保健专业人员在鉴别诊断中经常忽略肾脏 CE。在这项研究中,我们检查了尿路 CE 患者的临床和人口统计学特征,并分析了这种疾病的诊断和治疗程序。
回顾性分析了 19 例连续的新疆医科大学第一附属医院 1983 年 1 月至 2011 年 4 月收治的尿路 CE 患者的病历。所有病例均经病理检查和手术时肉眼观察证实为尿路 CE。
15 例为男性,4 例为女性。最常见的症状是非特异性腰痛和肾脏区域叩诊压痛。所有患者均在手术后随访 9-180 个月。无患者出现肾 CE 复发,但 4 例患者出现非肾包虫病复发。
肝和尿路中的细粒棘球蚴包虫结构相似。因此,世界卫生组织/包虫病非正式工作组(WHO/IWGE)制定的肝 CE 治疗方案也可用于尿路 CE。在我们的患者中,超声、计算机断层扫描、血清学和临床特征的使用提供了 66.7%至 92.3%的诊断准确性。