Rausch R L, Wilson J F, Schantz P M, McMahon B J
Am J Trop Med Hyg. 1987 May;36(3):576-85. doi: 10.4269/ajtmh.1987.36.576.
Nine cases of asymptomatic alveolar hydatid disease (AHD) of the liver were diagnosed in 1985 among Eskimos from the endemic region of western Alaska. The patients were identified by screening with the enzyme-linked immunosorbent assay, using purified Echinococcus multilocularis antigen (Em2 ELISA). Five patients, and one diagnosed earlier (1979), were found to have lesions in which the larval E. multilocularis had died spontaneously at an early stage of infection. Viability was assessed histologically; by the avidin-biotin immunohistochemical method; and in vivo through intraperitoneal inoculation of membranes of the larval cestode into red-backed voles, Clethrionomys rutilus. The results were in agreement with the clinical impression, based on findings by computerized tomography and ultrasound scanning, and on the macroscopic appearance of the lesions, that the cestode was dead. Spontaneous death of E. multilocularis in humans has not been previously reported. The findings show that the Em2 ELISA may be positive in patients having lesions of AHD in which the etiologic agent is no longer viable.
1985年，在阿拉斯加西部地方病流行区的爱斯基摩人中诊断出9例肝脏无症状肺泡型包虫病（AHD）。通过使用纯化的多房棘球绦虫抗原进行酶联免疫吸附测定（Em2 ELISA）筛查来确定患者。发现5例患者以及1例先前（1979年）诊断的患者，其病变中的多房棘球绦虫幼虫在感染早期已自然死亡。通过组织学、抗生物素蛋白-生物素免疫组织化学方法评估活力，并通过将幼虫绦虫膜腹腔接种到红背田鼠（Clethrionomys rutilus）体内进行体内评估。结果与基于计算机断层扫描和超声扫描结果以及病变宏观外观得出的临床印象一致，即绦虫已死亡。多房棘球绦虫在人类中自然死亡此前尚未见报道。研究结果表明，对于病因不再存活的AHD病变患者，Em2 ELISA可能呈阳性。
