[Alveolar echinococcosis: a dreadful orphan disease].
A WIDESPREAD DISEASE: Significant progress in screening for alveolar echinococcosis has reduced the number of new cases observed in Europe. Health education and serodetection campaigns have allowed earlier diagnosis and more effective treatment. The disease cannot however be totally eradicated due to the widespread wild reservoirs, sometimes even in the center of large cities.
Early diagnosed and treatment can inhibit the inevitable progression observed after clinical manifestations appear. Drugs can block disease progression and surgical excision can be most effective. Inversely, the hopes raised by liver transplantation in patients with advanced stage disease have not been fulfilled due to the more or less late-onset metastasis favored by immunosuppressive treatments.


CONCLUSIONS
There has been considerable progress in our knowledge of this parasite disease, particularly in improved diagnostic techniques. They have also demonstrated that humans are poor hosts for the parasite which is often spontaneously ejected. We are beginning to better understand the mechanisms of this spontaneous cure. Practical consequences would be a definition of receptive patient profiles or "vaccine" or immunotherapeutic procedures.
Houin
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R
Laboratoire de Parasitologie-Mycologie, Hôpital Henri Mondor AP-HP et Faculté de Médecine de Créteil. houin@univ-paris12.fr
Liance
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M
D015766:Albendazole / Q000008:administration & dosage / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000008:administration & dosage / Q000627:therapeutic use; D000969:Antinematodal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002415:Cats; D002986:Clinical Trials as Topic; D003937:Diagnosis, Differential; D004444:Echinococcosis, Hepatic / Q000175:diagnosis / Q000628:therapy / Q000635:transmission; D005589:Foxes; D006498:Hepatectomy; D006801:Humans; D016031:Liver Transplantation; D008463:Mebendazole / Q000008:administration & dosage / Q000627:therapeutic use; D015337:Multicenter Studies as Topic; D012307:Risk Factors; D013997:Time Factors
D000871:Anthelmintics; D000969:Antinematodal Agents; D008463:Mebendazole; D015766:Albendazole