Continuous albendazole therapy in alveolar echinococcosis: long-term follow-up observation of 20 cases.
Twenty patients with primary hepatic alveolar echinococcosis were treated with continuous long-term albendazole at a dose of 20 mg/kg/d for an average of 5.7 years (1.5-13.5 years) and were followed up for an average of 12.7 years (4.1-13.5 years). The therapeutic effects were evaluated by clinical, laboratory (haemogram, liver function tests), ultrasonography and computed tomography (CT) examinations. The CT pattern of hepatic lesions was classified into three types: solid form (5 cases), pseudocystic form (6 cases) and 'geographic map' (mixed) form (9 cases). Short-term results were encouraging. Jaundice and haemoptysis disappeared within 1 month of starting treatment, and hemiparesis in a patient with cerebral metastases also gradually improved. Treatment was less effective in two patients with advanced disease. On long-term follow-up, three patients were apparently cured, and the remaining 17 patients showed a good initial response, but recurrence occurred in 13 patients (65%). Therapeutic outcome was favourable with the solid form, but poor with the pseudocystic form. The mixed form was a transitional phase and slowly progressive. Involvement of the porta hepatis was the cause of various complications with high morbidity and mortality. Five patients (25%) died during the period of observation, the 10-year survival rate being, therefore, 75%.
Liu
Yue Han
YH
Institute of Infectious and Parasitic Diseases, The First Affiliated Hospital, Chongqing University of Medical Science, Chongqing, P.R.C. 400016.
Wang
Xiao Gen
XG
Gao
Jin Song
JS
Qingyao
Yun
Y
Horton
John
J
D000328:Adult; D000368:Aged; D015766:Albendazole / Q000627:therapeutic use*; D000818:Animals; D000923:Anticestodal Agents / Q000627:therapeutic use*; D002681:China; D004334:Drug Administration Schedule; D004444:Echinococcosis, Hepatic / Q000188:drug therapy* / Q000401:mortality; D048210:Echinococcus multilocularis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography
D000923:Anticestodal Agents; D015766:Albendazole