title: Alveolar echinococcosis of the liver: a single center experience.
abstract: BACKGROUND
  In humans, alveolar echinococcosis (AE) of the liver is caused by canine tapeworm called Echinococcus multilocularis. The disease is most prevalent in the northern hemisphere and in the eastern part of Turkey.
  
  
  OBJECTIVE
  The aim of the study was to review the natural history of AE and its clinical and radiological features.
  
  
  METHODS
  The retrospective study involved 23 patients (10 men, 13 women), aged 34-75 years with AE who had been referred to our liver disease clinic in the past 4 years. Only patients with pathologically proven AE were included in the study. The sociodemographic, clinical, and radiological features of AE were also evaluated.
  
  
  RESULTS
  The main laboratory characteristics of AE included mild eosinophilic leukocytosis with hypergammaglobulinemia, elevated C-reactive protein levels, near-normal liver transaminases, and increased levels of cholestatic enzymes and immunoglobulin E. Eight patients (35%) had hepatitis B e antigen-negative hepatitis B infection. Budd-Chiari syndrome was identified in 3 of 23 patients (13%). Eighty-three percent of the patients had a seropositive test result for AE, and approximately one-third of the patients had distant metastasis. Surgical treatment was administered in 4 patients. Four patients died due to complications during follow-up.
  
  
  CONCLUSIONS
  Patients with AE have numerous complications and advanced disease at the time of diagnosis. The clinical picture of AE comprises a number of hepatic and extrahepatic disturbances related both to destructive and mass effects of the tapeworm.
authors.affiliation: Yuzuncu Yil University, Medical Faculty, Department of Gastroenterology, Van, Turkey.
authors.forename: Ahmet C
authors.initials: AC
authors.lastname: Dulger
authors.forename: Ramazan
authors.initials: R
authors.lastname: Esen
authors.forename: Huseyin
authors.initials: H
authors.lastname: Begenik
authors.forename: Enver
authors.initials: E
authors.lastname: Aytemiz
authors.forename: Levent
authors.initials: L
authors.lastname: Demirtas
authors.forename: Mehmet
authors.initials: M
authors.lastname: Aslan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015766:Albendazole / Q000008:administration & dosage; D000818:Animals; D000923:Anticestodal Agents / Q000627:therapeutic use; D002648:Child; D004334:Drug Administration Schedule; D004444:Echinococcosis, Hepatic / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D048210:Echinococcus multilocularis / Q000302:isolation & purification; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000469:parasitology / Q000473:pathology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012698:Serologic Tests; D015996:Survival Rate; D055815:Young Adult
chemical_list: D000923:Anticestodal Agents; D015766:Albendazole