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تعداد صفحات این فایل: ۱۰ صفحه

بخشی از مقاله انگلیسیعنوان انگلیسی:Overview of Hydatid Disease in Iranian Children~~en~~

Abstract

Background: Hydatid disease (HD) is still an important health hazard in the world. This disease is a parasitic infestation endemic in many sheep- and cattle-raising areas such as Iran. Objectives: This study aimed to review the clinical manifestations, laboratory aspects, imaging findings, and management of HD. Patients and Methods: Data were collected from the medical records of patients diagnosed with HD in eight referral hospitals in different provinces of Iran from 2001 to 2014. Results: Overall, 161 children at a mean age of 9.25 ± ۳۳۷ years (age range = 1 – 15 years old) hospitalized with a definite diagnosis of the hydatid cyst between 2001 and 2014 were studied. The male-to-female ratio was 1.6:1. The most commonly involved organ was the lung (67.1%), followed by the liver (44.1%) and a combined liver and lung involvement was found in 15.5% of the patients. The cysts were found more frequently in the right lobe of the liver and lung than in the left lobe. The most frequent complaints were fever (35.4%) and abdominal pain (31.7%), and the most frequent sign was an abdominal mass in the liver involvement and cough in the lung involvement. There was a high eosinophil count (> 500/micL) in 41% of our cases. A high erythrocyte sedimentation rate (> 30) or positive C-reactive protein (based on the qualitative method) was found in 18.6% of the patients and leukocytosis > 15000/micL in 29.2% of the children. Ultrasonography was the main imaging test, with an accuracy rate of 96%, and chest X-ray was helpful in 88.6% of the cases. Surgery was performed in 89% of the patients, and selective patients underwent percutaneous aspiration-injection-reaspiration drainage or medical treatment. Conclusions: The lung was the most commonly involved organ in the children recruited in the present study. Given the high probability of multiple organ involvement, we recommend that patients with HD be assessed via ultrasonography and chest X-ray. In endemic regions, unexplained eosinophilia should be considered as a parasitic disease like HD and its complications.

۱- Background

Hydatid disease (HD), also known as hydatidosis, is still a global problem in highly endemic areas such as Iran (1, 2). The hydatid cyst is the larval stage of Echinococcus granulosus, which is hosted by dogs and other canines (3, 4). Humans are intermediate hosts by eating the tapeworm eggs (5). According to recent estimations, echinococcosis is responsible for about 1 – 220/10000 infections in the common areas (2, 6, 7). HD is commonly asymptomatic, and often the cysts are detected incidentally (8). In other cases, the symptoms vary largely and are non-specific, depending on the location, size, rupture, and infection of the cysts (9). The liver and lung are the most commonly involved organs in humans; and in children, the lung is more frequently infected (10-14). An elevated eosinophil count in a patient from an endemic region accompanied by non-specific symptoms such as abdominal pain, abdominal mass, and cough, is suggestive of HD (15). The diagnosis is usually made via imaging modalities (i.e. ultrasonography and chest Xray) and confirmed by pathology (16). Surgery is the chief therapeutic method for the management of HD, although currently percutaneous aspiration-injection-reaspiration drainage is regarded as a first choice in many cases (9, 14). The present study was performed to evaluate the epidemiological aspects, clinical presentations, paraclinical findings, and management of HD in Iranian children.

۲- Objectives

We sought to review the clinical manifestations, laboratory aspects, imaging findings, and management of HD.

۳- Patients and Methods

In this retrospective study, we investigated the medical records of 161 patients (1 – 15 years old) with a definite diagnosis of HD admitted to eight major referral hospitals of Iran during a 13-year period (2001 – 2013). Data were collected on sex, age, clinical manifestations, anatomical location of the cysts, size and number of the cysts, laboratory tests, and therapeutic management. Statistical analysis was carried out using statistical package for the social sciences (SPSS) version 18.

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