Evaluation of the Serological, Biochemical and Hemogram Parameters of Patients Prediagnosed with Hydatid Cyst

Abstract

Objective: Hydatid cyst or echinococcosis is a zoonotic parasitic disease caused by the larval stages of Echinococcus granulosus, which is common in our country. It is necessary to use radiological and serological methods as diagnosing this disease based on clinical symptoms is very difficult. In this retrospective study, it was aimed to determine the condition in our region by retrospectively analyzing the hemogram, biochemistry, radiological and pathological findings and the epidemiological data of the patients prediagnosed with hydatid cyst. Materials and Methods: A total of 412 patients, 279 female and 133 male, who applied to various clinics of the Mardin State Hospital with hydatid cyst prediagnosis. 52 patients were diagnosed with hydatid cyst based on ultrasonography, computerized tomography and radiological findings, and liver involvement was detected in all 64 patients, 12 of which were pathologically verified. Results: 38 (59.3%) of 64 patients included in the study were female, 26 (40.6%) were male and their ages ranged from 0-77. The most common symptoms were severe abdominal pain, distention, chest pain, shortness of breath, cough, fever, nausea and vomiting. 83.4% of the patients applied to the general surgery, 5.5% applied to the pediatric surgery and 10.1% applied to other clinics. Conclusion: The parameter with the highest increase was GGT, followed by ALT, AST and ALP. Elevated RDW (29%) was the most common finding in the hemogram parameters, followed by decreased MCV, hematocrit and hemoglobin.

Keywords

• Hydatid cyst
• echinococcosis
• Echinococcus granulosus
• diagnosis
• epidemiology

Kistik Ekinokokkoz Ön Tanısı ile Başvuran Hastaların Radyolojik, Hemogram ve Biyokimyasal Analizlerinin Değerlendirilmesi

Abstract

Giriş ve Amaç: Hydatid cyst ya da echinococcosis, ülkemizde yaygın olarak görülen Echinococcus granulosus’un neden olduğu ve larval dönemin oluşturduğu zoonotik paraziter bir hastalıktır. Klinik semptomlarla bu hastalığın tanısını koymak oldukça zor olduğundan radyolojik ve serolojik yöntemlerin kullanılması gerekmektedir. Bu retrospektif çalışmada, kist hidatik ön tanısı konulan hastaların hemogram, biyokimya, radyolojik, patolojik bulguları ile epidemiyolojik verileri geriye dönük olarak incelenerek bölgemizdeki durumun belirlenip değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya, Kamu Hastaneler Birliği Mardin Devlet Hastanesine kist hidatik ön tanısı ile çeşitli kliniklere başvuran 279’u kadın 133’ü erkek olmak üzere toplam 412 hasta dahil edilmiştir. 412 hastadan 52’ine ultrasonografi, bilgisayarlı tomografi ve radyolojik bulgular ile kist hidatik tanısı konulmuş olup 12’sinde patolojik olarak doğrulanmış toplam 64 hastanın hepsinde karaciğerde tutulumunun olduğu saptanmıştır. Bulgular: Çalışmaya alınan 64 hastanın 38 (%59.3)’i kadın, 26 (%40.6)’sı erkek olup yaşları 0 ile 77 arasında değişmektedir. Hastalarda şiddetli karın ağrısı, karın şişliği, göğüs ağrısı, nefes darlığı, öksürük, ateş, bulantı, kusma en sık olarak saptanan semptomlardır. Hastaların sırasıyla; %83.4’ü genel cerrahi, %5.5’inin çocuk cerrahisi ve %10.1’inin ise diğer kliniklerine başvurduğu belirlenmiştir. Sonuç: Biyokimyasal olarak tanı anında en sık yükselen test GGT olup, bunu ALT, AST, ALP artışı izlemiştir. Hemogram parametrelerinde RDW yüksekliği (%29) en sık rastlanılan bulgu olup, bunu hematokrit, hemoglobin ve MCV düşüklüğü sırayla takip etmiştir.

Keywords

• Kist hidatik
• Ekinokokkozis
• Echinococcus granulosus
• tanı
• epidemiyoloji

References

1. McManus, D.P., Characterization of echinococcus (hydatid disease) strains in Europe using DNA probes, Med Chir Dig, 1988, 17: 293-295.
2. Eckert, J, Deplazes, P, Biological epidemiological and clinical aspects of echinococcosis, a zoonosis of increasing concern, Clin Microbiol Rev, 2004, 17: 107-135.
3. Yılmaz, G.R, Babur, C, Ekinokokkozis tanısı, Türk Hij Den Biyol Derg, 2007, 64, 35-44.
4. Yuksel, M, Demirpolat, G, Sever, A, et al., Hydatid disease involving some rare locations in the body: a pictorial essay, Korean J Radiol, 2007, 8, 531-540.
5. Moro, P, Scantz, P.M, Ecinococcosis: a review, Int J Infect Dis, 2009, 13, 125-133.
6. Demirhan, R, Onan, B, Kiral, H, et al., Surgical treatment of giant hydatid cysts in childhood, Turkish J Thorac and Cardiovasc Surg, 2010, 18, 121-125.
7. Sayek, I, Tirnaksiz, M.B, Dogan, R, Cystic Hydatid Disease: Current trends in diagnosis and management, Surg Today, 2004, 34, 987-996.
8. Acarli, K, Controversies in the laparoscopic treatment of hepatic hydatid disease, HPB, 2004, 6, 213-221.

9. Altintas, N, Past to present: echinococcosis in Turkey, Acta Trop, 2003, 85, 105-112.
10. Yazar, S, Ozkan, A.T, Hokelek, M, et al., Türkiye’de 2001-2005 yılları arasında kistik ekinokokkozis, Turkiye Parazitol Derg, 2008, 32, 208-220.
11. Mandal, S, Mandal, M.D, Human cystic echinococcosis: epidemiologic, zoonotic, clinical, diagnostic and therapeutic aspects, Asian Pac J Trop Med, 2012, 5, 253-260.
12. Eilbı̇gı̇, M.M, The results of radiological and serological screeningin individuals sharing the same life area with treatment of cyst hydatid patients inAfghanistan’s Sibirgan Satate Hospital, Selcuk University, Institute of Health Sciences, Konya, Turkey. Specialization in Medicine, 2018, 541744.
13. Baris, I, Sahin, A, Bilir, N, et al., Hidatik Kist Hastalığı ve Türkiye’deki Konumu. Türkiye Akciğer Hastalıkları Vakfı Yayını No: 1 Ankara, 1989.
14. Rajaii, M, Comparison of ELISA and IHA Diagnostic tests in the detection of human Hydatidosis in Tabriz, IMJ 2005, 4, 14-16.
15. Kilic, S, Babur, C, Taylan, O.A, Kist hidatik ön tanılı olgularda indirek hemaglütinasyon ve ELISA yöntemleri ile alınan sonuçların karşılaştırılması, Mikrobiyol Bul, 2007, 41, 571-575.
16. Aytekin, I, Diagnosis of pulmonary hydatic cyst or pulmonary and liver hydatic cysts between August 2002 and March 2011 are investigated. Gazi University, Faculty of Medicine, Department of Thoracic Surgery, Ankara, Turkey. Specialization in Medicine 2011, 281536.
17. Gokcen, A, Kistik ekinokokkozda aşı çalışmaları, T Parazitol Derg, 2000, 24, 419- 425.
18. Kokturk, O, Akciğer Hidatik Kist Hastalığı. In: Ekim N, Ucan ES, eds. Solunum Sistemi İnfeksiyonları, Toraks Kitapları, 2001, 3, 557-604.
19. Isitmangil, T, Sebit, S, Tunc, H, et al., Clinical experience of surgical therapy in 207 patients with thoracic hydatizosis over a 12 years period Swiss Med WKLY, 2002, 132, 548-552.
20. Dogan, R, Yuksel, M, Cetin, G, et al., Surgical treatment of hydatid cysts of the lung; Report on 1055 patients, Thorax, 1989, 44, 192-199.
21. Arienti, H.M, Guignard, S.I, Rinaldi, D.E, et al., Comparison of two serologic methods for the diagnosis of hydatidosis, Pan Am J Public Health, 1997, 1, 376-380.
22. Aslan, M, Yuksel, P, Polat, E, et al., The diagnostic value of Western blot method in patients with cystic echinococcosis, New Microbiol, 2011, 34, 173-177.
23. Larrieu, E, Uchiumi, L, Salvitti, J.C, et al., Epidemiology, diagnosis, treatment and follow-up of cystic echinococcosis in asymptomatic carriers, Trans R Soc Trop Med Hyg, 2018, 113, 74–80
24. Ozdemir, G.B, Demographic investigation of medical and surgical treatments in our clinic between January 2000-December 2016 years due to cyst hydatid. Sağlık Bı̇lı̇mlerı̇ University, Behcet Uz Children's Diseases and Surgery Suam Pediatric Surgery, Izmir, Turkey, Specialization in Medicine, 2018, 508001
25. Sahin, E.M, Yuksek, Y.N, Daglar, G, et al., Diagnosis and treatment of hydatid cysts: results of 120 patients, Trakya Univ Tip Fak Derg, 2008, 25, 6-14.
26. Apaydin, T, Basaran, C, A giant cystic echinococcosis of the lung in East Turkey, Ann Med Surg (Lond), 2018, 36, 51-53.
27. Ghandour, R, Nassar, G, Hejase, M.J, Renal Echinococcosis mistaken for a cystic renal tumor: A case report, Urology Case Reports, 2020, 28, 101030
28. Kumar, N, Garg, R, Namdeo, R, Primary pelvic hydatid cyst: A rare case presenting with obstructive uropathy, Int J Surg Case Rep, 2018, 53, 277-280.
29. Karadagli, E, Gürses, D, Akpınar, F, et al., Four Hydatid Cysts in One Family: Is Family Screening Necessary, Turkiye Parazitol Derg, 2015, 39, 319-322.