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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2017 November;176(11):603-9

DOI: 10.23736/S0393-3660.17.03430-1

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Fasciola hepatica infestation in Turkish children

Yavuz TOKGÖZ 1 , Müsemma KARABEL 2, Gökhan BAYSOY 3, Cemil GÖYA 4, Muttalip ÇIÇEK 5, Ayfer G. PIRINÇÇIOĞLU 2, Ünal ULUCA 2, Velat ŞEN 2

1 Department of Pediatric Gastroenterology, Hepatology and Nutrition, Diyarbakır Children Hospital, Diyarbakır, Turkey; 2 Department of Pediatrics, School of Medicine, Dicle University, Diyarbakır, Turkey; 3 Department of Pediatric Gastroenterology, Hepatology and Nutrition, School of Medicine, Dicle University, Diyarbakır, Turkey;4 Department of Radiology, School of Medicine, Dicle University, Diyarbakır, Turkey; 5 Dicle University, School of Medicine, Department of Parasitology, Diyarbakır, Turkey


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BACKGROUND: The data on childhood fascioliasis are limited. We aimed to heighten physicians’ awareness of Fasciola Hepatica by presenting 14 cases in this paper.
METHODS: The medical records of pediatric patients treated for F. Hepatica infection within the last 2 years were reviewed. ELISA method with a cut-off level of 10 was used as the serological test, in which an absorbance level of >11 DU/mL was considered positive.
RESULTS: Ten (71.4%) patients were female. Complaints at presentation were abdominal pain (N.=14; 100%) and loss of appetite (N.=12; 85.7%). Twelve (85.7%) patients were from rural areas. All patients had an elevated eosinophil count (mean: 3885.6/mm3, minimum: 566/mm3, maximum: 18687/mm3). Six patients had a leucocyte count >10.000 cells/mm3 and 8 (57%) patients had an ESR>20 mm/h. Gamma-glutamyt transferase (GGT) was normal in all but 1 patient presenting with cholangitis. In hepatobiliary ultrasonography (USG) the most common finding was a heterogeneous solid lesion found in 11 patients. Advanced imaging methods revealed multiple cystic lesions in 10 patients and magnetic resonance imaging (MRI) showed hypo-hyperintense hepatic parenchymal changes in 9 patients. The patients were started on Triclabendazole 10 mg/kg/dose. Clinical, laboratory, and radiological findings of the patients were improved after the therapy.
CONCLUSIONS: Fascioliasis should be suspected in children from endemic regions presenting with abdominal pain, weight loss, and fever, which are accompanied by eosinophilia, elevation in transaminases, and cystic/solid lesions in liver, particularly in bile ducts or parenchyma. Triclabendazole is very effective for treatment of this disease.


KEY WORDS: Fasciola hepatica - Parasitic diseases - Child

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