Abstract：
BACKGROUND: Alveolar echinococcosis is an endemic parasitic disease prevalent in certain cold regions of the Northern Hemisphere, including Eastern France, Switzerland, Germany, Canada, and the United States. Widely underdiagnosed, it is associated with infection by Echinococcus multilocularis, a small tapeworm belonging to the cestode class, capable of causing multi-systemic involvement, particularly in elderly or immunocompromised patients.
METHODS: We present the case of an 82-year-old patient, immunocompromised due to prolonged corticosteroid therapy and treatment with dupilumab. She was referred to our department for a diagnostic assessment of atypical hepatic and pulmonary lesions, initially suspected of tuberculosis or an IgG4-related disease. The hypothesis of alveolar echinococcosis caused by E. multilocularis was eventually considered based on a set of arguments, further confirmed by molecular diagnosis. We discuss the role of dupilumab in the systemic evolution and atypical presentation of the disease, through the induction of a specific immunosuppression.
CONCLUSIONS: Alveolar echinococcosis should be systematically considered in case of systemic disease with prominent hepatic and pulmonary involvement, especially in immunocompromised patients.
METHODS: We present the case of an 82-year-old patient, immunocompromised due to prolonged corticosteroid therapy and treatment with dupilumab. She was referred to our department for a diagnostic assessment of atypical hepatic and pulmonary lesions, initially suspected of tuberculosis or an IgG4-related disease. The hypothesis of alveolar echinococcosis caused by E. multilocularis was eventually considered based on a set of arguments, further confirmed by molecular diagnosis. We discuss the role of dupilumab in the systemic evolution and atypical presentation of the disease, through the induction of a specific immunosuppression.
CONCLUSIONS: Alveolar echinococcosis should be systematically considered in case of systemic disease with prominent hepatic and pulmonary involvement, especially in immunocompromised patients.
摘要：
背景：肺泡包虫病是北半球某些寒冷地区流行的地方性寄生虫病，包括法国东部,瑞士,德国,加拿大,和美国。广泛诊断不足，它与多房棘球蚴感染有关，一种属于cestode类的小tape虫，能够引起多系统的参与，尤其是老年或免疫功能低下的患者。
方法：我们介绍了一个82岁的患者，由于长期的皮质类固醇治疗和dupilumab治疗而导致的免疫功能低下。她被转诊到我们部门进行非典型肝和肺部病变的诊断评估，最初怀疑结核病或IgG4相关疾病。由多房性大肠杆菌引起的泡状包虫病的假设最终被认为是基于一组论点，分子诊断进一步证实。我们讨论了dupilumab在疾病的系统演变和非典型表现中的作用，通过诱导特异性免疫抑制。
结论：对于肝脏和肺部受累的全身性疾病，应系统地考虑肺泡包虫病。尤其是免疫功能低下的患者。
方法：我们介绍了一个82岁的患者，由于长期的皮质类固醇治疗和dupilumab治疗而导致的免疫功能低下。她被转诊到我们部门进行非典型肝和肺部病变的诊断评估，最初怀疑结核病或IgG4相关疾病。由多房性大肠杆菌引起的泡状包虫病的假设最终被认为是基于一组论点，分子诊断进一步证实。我们讨论了dupilumab在疾病的系统演变和非典型表现中的作用，通过诱导特异性免疫抑制。
结论：对于肝脏和肺部受累的全身性疾病，应系统地考虑肺泡包虫病。尤其是免疫功能低下的患者。
