Kidney invasion occurred 2 years following liver transplantation for hepatic alveolar echinococcosis: a case report.
Albendazole
Alveolar echinococcosis
Case report
Immunosuppression therapy
Liver transplantation
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
10 Nov 2023
10 Nov 2023
Historique:
received:
06
09
2023
accepted:
04
11
2023
medline:
13
11
2023
pubmed:
11
11
2023
entrez:
11
11
2023
Statut:
epublish
Résumé
The organ most commonly invaded in echinococcosis is the liver; the lungs, brain, kidneys, heart, and spleen are rarely invaded, and multi-organ involvement in echinococcosis is even rarer. No studies have reported renal invasion after liver transplantation for hepatic alveolar echinococcosis. We report here a case of renal invasion 2 years after allogeneic liver transplantation in a 53-year-old female patient with hepatic alveolar echinococcosis combined with lung metastases. At the time of the first consultation, the lesion had been found to involve the second hepatic hilum combined with lung metastases, but the patient requested conservative treatment, and the lesion was not controlled by taking albendazole for 3 years. After discussion in the treatment group, it was decided to use allogeneic liver transplantation and lung segmental resection for surgical treatment, after which the patient was put on long-term oral immunosuppression. She was hospitalized 2 years later for low back pain and diagnosed with renal alveolar echinococcosis. Due to significant compression and left-sided renal insufficiency, the final option was to remove the diseased kidney. It is worth mentioning that signs of unexplained urinary tract infection were present throughout the course of treatment. This study suggests that extra attention should be paid to the presence of cryptogenic lesions in patients with hepatic alveolar echinococcosis who already have definite metastatic lesions. Immunosuppressive drugs after liver transplantation in patients with hepatic echinococcosis may cause occult lesions to develop into active ones. In clinical practice, particular attention should be paid to patients with hepatic alveolar echinococcosis with long-term concomitant signs of unexplained urinary tract infections, which may be a precursor clinical feature of cryptogenic renal alveolar echinococcosis.
Sections du résumé
BACKGROUND
BACKGROUND
The organ most commonly invaded in echinococcosis is the liver; the lungs, brain, kidneys, heart, and spleen are rarely invaded, and multi-organ involvement in echinococcosis is even rarer. No studies have reported renal invasion after liver transplantation for hepatic alveolar echinococcosis.
CASE PRESENTATION
METHODS
We report here a case of renal invasion 2 years after allogeneic liver transplantation in a 53-year-old female patient with hepatic alveolar echinococcosis combined with lung metastases. At the time of the first consultation, the lesion had been found to involve the second hepatic hilum combined with lung metastases, but the patient requested conservative treatment, and the lesion was not controlled by taking albendazole for 3 years. After discussion in the treatment group, it was decided to use allogeneic liver transplantation and lung segmental resection for surgical treatment, after which the patient was put on long-term oral immunosuppression. She was hospitalized 2 years later for low back pain and diagnosed with renal alveolar echinococcosis. Due to significant compression and left-sided renal insufficiency, the final option was to remove the diseased kidney. It is worth mentioning that signs of unexplained urinary tract infection were present throughout the course of treatment.
CONCLUSION
CONCLUSIONS
This study suggests that extra attention should be paid to the presence of cryptogenic lesions in patients with hepatic alveolar echinococcosis who already have definite metastatic lesions. Immunosuppressive drugs after liver transplantation in patients with hepatic echinococcosis may cause occult lesions to develop into active ones. In clinical practice, particular attention should be paid to patients with hepatic alveolar echinococcosis with long-term concomitant signs of unexplained urinary tract infections, which may be a precursor clinical feature of cryptogenic renal alveolar echinococcosis.
Identifiants
pubmed: 37950231
doi: 10.1186/s12879-023-08788-7
pii: 10.1186/s12879-023-08788-7
pmc: PMC10638689
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
785Subventions
Organisme : National Natural Science Foundation of China
ID : 81960576
Organisme : Qinghai Provincial Department of Science and Technology
ID : No. 2020-ZJ-Y01
Informations de copyright
© 2023. The Author(s).
Références
Transplant Proc. 2016 Jun;48(5):1708-12
pubmed: 27496476
BMC Infect Dis. 2022 May 23;22(1):489
pubmed: 35606711
Am J Transplant. 2016 Feb;16(2):615-24
pubmed: 26460900
Prog Urol. 2012 Dec;22(16):999-1003
pubmed: 23178095
Langenbecks Arch Surg. 2003 Sep;388(4):231-8
pubmed: 12905036
J Hepatol. 2018 Nov;69(5):1037-1046
pubmed: 30031886
Clin Microbiol Rev. 2019 Feb 13;32(2):
pubmed: 30760475
J Infect Dev Ctries. 2020 May 31;14(5):420-427
pubmed: 32525824
Adv Parasitol. 2017;96:259-369
pubmed: 28212790
BMJ. 2012 Jun 11;344:e3866
pubmed: 22689886
Infect Dis (Lond). 2018 Jun;50(6):452-459
pubmed: 29363377