Summary
Since 1976 60 patients with inoperable alveolar echinococcosis caused by Echinococcus multilocularis were treated with high doses of mebendazole and examined at regular intervals prospectively according to our protocol regarding clinical course, liver function, morphology, immunologically and plasma mebendazole levels. The average duration of disease was 8(1–19) years, the average duration of chemotherapy was 4.25 (0.75–9) years. The long term results showed a correlation of the clinical course with the mean plasma mebendazole levels and the duration of chemotherapy, respectively. Death (n=5) or transient progression of the disease process (n=14) was observed primarily in patients with low plasma mebendazole levels in the early course and within the first two years of chemotherapy. Only 9 patients showed a decrease of the parasite mass. Immundiagnosis (total serum IgE and serum antibodies against Echinococcus antigen) gave some information with regard to therapy results, but only in the long-term course. The cumulative survival of the patients under study was 96% at 5 years and 84% at 10 years, respectively which is markedly higher compared to historical control series with a letality of >90% within 10 years.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- SESG:
-
Schweizerische Echinokokkose-Studiengruppe
- E.m.:
-
Echinococcus multilocularis (alveolaris)
- CT:
-
Computertomographie
- IIF:
-
Indirekte Immunfluoreszenz
- KG:
-
Kontrollgruppe; (Lm, Hs, Alt etc. Initialen der Patienten (identisch wie in früheren Publikationen)
Literatur
Ammann RW (1983) Diagnose und Therapie der Echinokokkose. Schweiz Rundschau Med (Praxis) 72:1568–1572
Davis A, Pawlowski ZS, Dixon H (1986) Multicentre clinical trials of benzimidazolcarbamates in human echinococcosis. Bull WHO 64:383–388
Eckert J (1986) Prospect of the metacestode stage of echinococcus. In: Thompson RCA (ed) The biology of echinococcosis: George Allen & Unwin, London Boston Sidney, pp 250–284
Gottstein B, Eckert J, Woodtli W (1984) Determination of parasitespecific immunoglobulins using the ELISA in patients with echinococcosis treated with mebendazole. Z Parasitenkd 70:385–389
Gottstein B, Witassek F, Eckert J (1986) Neues zur Echinokokkose. Schweiz Med Wschr 116:810–817
Junge U, Rengstorf U (1986) Mebendazol bei Echinococcus multilocularis: lebenslang? Z Gastroenterol (Kurzfassung) 24:458
Kern P (1983) Human echinococcosis: Follow up of 23 patients treated with mebendazole. Infection 11:17–24
Knobloch J, Biedermann H, Mannweiler E (1985) Serum antibodies in patients with alveolar echinococcosis before and after therapy. Trop med Parasit 36:155–156
Lasségue A, Estavoyer JM, Minazzi H, Barale T, Gillet M, Vuitton D, Miquet J-P (1984) Traitement de l'échinococcose alvéolaire humaine par le flubendazole. Etude clinique, morphologique et immunologique. Gastroentreol Clin Biol 8:314–320
Luder PJ, Robotti G, Meister FP, Bircher J (1985) High oral doses of mebendazole interfere with growth of larval echinococcus multilocularis lesions. J Hepatol 1:369–377
Luder PJ, Siffert B, Witassek F, Meister F, Bircher J (1986) Treatment of hydatid disease with high oral doses of mebendazole. Long term follow up of plasma mebendazole levels and drug interactions. Eur J Clin Pharmacol 31:443–448
Müller E, Akovbiantz A, Ammann RW, Bircher J, Eckert J, Wissler K, Witassek F, Wüthrich B (1982) Treatment of human echinococcosis with mebendazole. Preliminary observations in 28 patients. Hepato-Gastroenterol 29:236–239
Rausch RL, Wilson JF, McMahon BJ, O'Gorman MA (1986) Consequences of continuous mebendazole therapy in alveolar hydatid disease with a summary of a ten year clinical trial. Ann Trop Med Parasitol 80:403–419
Roche G, Canton Ph, Gerard A, Colin D, Boissel P, Chaulieu C, Dureux JB (1982) Essai de traiement de l'échinococcose alvéolaire par le flubendazole. A propos de 7 observations. Médicine et maladies infectieuses 12:218–230
Schantz PM, Van den Bossche H, Eckert J (1982) Chemotherapy for larval echinococcosis in animals and humans. Report of a Workshop. Z Parasitenkd 67:5–26
Schantz PM, Wilson JF, Wahlquist SP, Boss LP, Rausch RL (1983) Serologic tests for diagnosis and post treatment evaluation of patients with alveolar hydatid disease (echinococcosis multilocularis). J Trop Med Hyg 32:1381–1386
Wilson JF, Rausch RL (1982) Mebendazole and alveolar hydatid disease. Ann Trop Med Parasitol 76:165–173
Witassek F, Burkhardt B, Eckert J, Bircher J (1981) Chemotherapy of alveolar echinococcosis. Comparison of plasma mebendazole concentrations in animals and man. Eur J Clin Pharmacol 20:427–433
Woodtli W, Bircher J, Witassek F, Eckert J, Wüthrich B, Ammann RW (1985) Effect of plasma mebendazole concentrations in the treatment of human echinococcosis. Am J Trop Med Hyg 34:745–760
Author information
Authors and Affiliations
Additional information
Unterstützt durch den Schweiz. Nationalfonds, Projekt No. 3.965-0.82 und No. 3.958-0.85 sowie Theodor und Ida Herzog Egli-Stiftung
Rights and permissions
About this article
Cite this article
Ammann, R., Tschudi, K., von Ziegler, M. et al. Langzeitverlauf bei 60 Patienten mit alveolärer Echinokokkose unter Dauertherapie mit Mebendazol (1976–85). Klin Wochenschr 66, 1060–1073 (1988). https://doi.org/10.1007/BF01711918
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01711918