Vuitton Dominique Angèle, Mantion Georges, Million Laurence, Bresson-Hadni Solange
Université Bourgogne Franche-Comté, Besançon, France.
Centre national de référence pour les échinococcoses, CHU de Besançon, Besançon, France.
Rev Prat. 2020 Sep;70(7):754-764.
Alveolar echinococcosi. Alveolar echinococcosis is a parasitic anthropo-zoonosis which looks like a slow-growing liver cancer. The lesions progressively obstruct hepatic vessels and bile ducts and invade neighboring organs, and it may metastasize to the lung and the brain and possibly all distant organs. Since the 1990s earlier diagnosis by imaging, advances in surgical and less invasive interventions, and prolonged anti-parasitic treatment using albendazole, have totally transformed the prognosis of the disease. However, in Europe, the endemic area has considerably increased, the number of alveolar echinococcosis cases has more than doubled in the previously identified endemic regions, and the disease may now be considered to be an 'opportunistic infection', especially diagnosed in those patients treated with immunosuppressive drugs and biologic agents. Alveolar echinococcosis is currently more and more often diagnosed incidentally, at an early stage of development, and not in the usual 'at risk' regions and populations. This makes differential diagnosis and care management more challenging.
泡型包虫病。泡型包虫病是一种人兽共患寄生虫病,其症状类似生长缓慢的肝癌。病变会逐渐阻塞肝血管和胆管,并侵犯邻近器官,还可能转移至肺和脑,甚至可能转移至所有远处器官。自20世纪90年代以来,通过影像学进行早期诊断、外科手术及微创干预技术的进步,以及使用阿苯达唑进行长期抗寄生虫治疗,已彻底改变了该病的预后。然而,在欧洲,流行区域显著扩大,在先前已确定的流行地区,泡型包虫病病例数增加了一倍多,现在该病可被视为一种“机会性感染”,尤其在接受免疫抑制药物和生物制剂治疗的患者中被诊断出来。目前,泡型包虫病越来越多地在疾病发展的早期阶段被偶然诊断出来,且并非在通常的“高危”地区和人群中。这使得鉴别诊断和治疗管理更具挑战性。