Dicrocoelium dentriticum in explanted liver, report of an unusual finding

سال انتشار: 1395
محل انتشار: هجدهمین همایش سالانه و اولین همایش بین المللی آسیب شناسی و طب آزمایشگاه
کد COI اختصاصی: ACPLMED18_005
زبان مقاله: انگلیسی
تعداد مشاهده: 564

نویسندگان

cancer research institute,pathology department,Imam Khomeini Hospital,Tehran university of medical sciences

چکیده

Dicrocoelium dentriticum; a member of Trematode helminthes, is a liver parasite of ruminants. Humans are infected accidentally by ingestion of intermediate host; infected ants via eating of uncooked raw vegetables or drinking contaminated water. Infection is often asymptomatic or had subtle symptoms, so usually unrecognized. However it can produce chronic cholangitis and swelling or adenomatous proliferation in the bile ducts and lead to abdominal pain, diarrhea, fatigue, jaundice and etc.Spurious infection in endemic areas due to eating of contaminated animal liver is seen, even so frequent than true infection. For diagnosis of true Dicrocoelium infection, stool examination for finding of parasite’s ova after at least 3-day liver-free diet is necessary. We report a 49 year-old lady; known case of end stage hepatic cirrhosis due to viral hepatitis B + D co-infection. She has been complaining of pruritus in addition to hypoglycemic attack, abdominal pain and mild icterus. All symptoms refered to hepatic insufficiency. Also she had history of cholecystectomy several years ago. In a short time after transplantation , obstructive biliary signs such as direct bilirubinemia, moderate raise in serum aminotransferases and fever were appeared. Liver core needle biopsy was done 24-hour after transplantation for ruling out of rejection. In a same time explanted liver examined in path lab and show dilatation of hilar biliary ducts. Microscopic examination of liver core biopsy rule out rejection. Prepared sections of explanted liver revealed active cirrhosis associated with ductular proliferation . A helminth found in common bile duct. Morphologic reconstruction of helminth by microscopic findings and consultation with an expert parasitologist supported the diagnosis of Dicrocoelium dentriticum. The patient stool exam showed no any parasite’s ova . Praziquantel (40mg/kg three times a day) and Albendazole (400mg twice a day) were administered for the patient and dramatic clinical improvement appeared.

کلیدواژه ها

dicrocoelium, liver, transplantation

مقالات مرتبط جدید

اطلاعات بیشتر در مورد COI

COI مخفف عبارت CIVILICA Object Identifier به معنی شناسه سیویلیکا برای اسناد است. COI کدی است که مطابق محل انتشار، به مقالات کنفرانسها و ژورنالهای داخل کشور به هنگام نمایه سازی بر روی پایگاه استنادی سیویلیکا اختصاص می یابد.

کد COI به مفهوم کد ملی اسناد نمایه شده در سیویلیکا است و کدی یکتا و ثابت است و به همین دلیل همواره قابلیت استناد و پیگیری دارد.