ArticlePLoS neglected tropical diseases2014
Long-term sonographic and serological follow-up of inactive echinococcal cysts of the liver: hints for a "watch-and-wait" approach.
Article in PLoS neglected tropical diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 3 of them syntheses that pooled it.
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Who cites it
40 citing papers in PubMed, 3 syntheses or guidelines pooled it, 81 citations in OpenAlex.
- Treatment of uncomplicated hepatic cystic echinococcosis (hydatid disease).The Cochrane database of systematic reviews · 2024Pooled it
- Serology for the diagnosis of human hepatic cystic echinococcosis and its relation with cyst staging: A systematic review of the literature with meta-analysis.PLoS neglected tropical diseases · 2021Pooled it
- Medical treatment of cystic echinococcosis: systematic review and meta-analysis.BMC infectious diseases · 2018Pooled it
- Recent advances in clinical and laboratory diagnosis of hydatid cyst: from imaging to recombinant and nanobiosensor-based approaches.Infection · 2026Review
- The Role of Innate Lymphoid Cells in the Pathogenesis of Hepatic Echinococcosis: A Literature Review.Parasite immunology · 2026Review
- Long-term outcomes after open total pericystectomy for cystic echinococcosis.World journal of gastrointestinal surgery · 2025Article
- The patterns of diagnosis approaches, involved organs, and clinical symptoms and signs of hydatid cyst patients: a case series study from Northern Iran.Journal of parasitic diseases : official organ of the Indian Society for Parasitology · 2025Article
- The Diagnostic Challenge of Cystic Echinococcosis in Humans: First Assessment of Underreporting Rates in Mongolia.Tropical medicine and infectious disease · 2024Article
- Imaging features and management of focal liver lesions.World journal of radiology · 2024Review
- Comparison of Native Hydatid Cyst Fluid (HCF), Lyophilized HCF, Antigen B (AgB) and Lyophilized AgB (LAgB) Originated fromIranian journal of public health · 2023Article
- Antigen discovery by bioinformatics analysis and peptide microarray for the diagnosis of cystic echinococcosis.PLoS neglected tropical diseases · 2023Article
- Findings of a community screening programme for human cystic echinococcosis in a non-endemic area.PLOS global public health · 2022Article
- Accuracy of an experimental whole-blood test for detecting reactivation of echinococcal cysts.PLoS neglected tropical diseases · 2021Article
- Promising proteins detected by Western blot from Echinococcus granulosus protoscoleces for predicting early post-surgical outcomes in CE-affected Tunisian children.Parasites & vectors · 2021Article
- Proteomic analysis of plasma exosomes from Cystic Echinococcosis patients provides in vivo support for distinct immune response profiles in active vs inactive infection and suggests potential biomarkers.PLoS neglected tropical diseases · 2020Article
- Comparative Evaluation ofJournal of laboratory physicians · 2020Article
- Comment on: "Complications Associated with Initial Clinical Presentation of Cystic Echinococcosis: A 20-year Cohort Analysis".The American journal of tropical medicine and hygiene · 2020Article
- Prevalence and risk factors associated with human cystic echinococcosis in rural areas, Mongolia.PloS one · 2020Article
- Shortage of Albendazole and Its Consequences for Patients with Cystic Echinococcosis Treated at a Referral Center in Italy.The American journal of tropical medicine and hygiene · 2018Article
- Ultrasound and Cystic Echinococcosis.Ultrasound international open · 2018Review
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Human cystic echinococcosis is a chronic, complex and neglected infection. Its clinical management has evolved over decades without adequate evaluation of efficacy. Recent expert opinion recommends that uncomplicated inactive cysts of the liver should be left untreated and solely monitored over time ("watch-and-wait" approach). However, clinical data supporting this approach are still scant and published mostly as conference proceedings. In this study, we report our experience with long-term sonographic and serological follow-up of inactive cysts of the liver. From March 1994 to October 2013, 38 patients with 47 liver cysts, diagnosed as inactive without any previous treatment history, were followed with ultrasound and serology at 6-12 months intervals for a period of at least 24 months (median follow-up 51.95 months) in our outpatient clinic. In 97.4% of patients, the cysts remained inactive over time and in only one case was reactivation of the cyst detected. No complications occurred during the time of monitoring. During follow-up, serology tests for CE were negative at diagnosis or became negative in 74.1% and were positive or became positive in 25.9% of cases. Patients with inactive cysts on ultrasound but positive serological tests were also investigated by CT scan (chest and abdomen) to rule out extra-hepatic cyst localization. This study confirms the importance of a stage-specific approach to the management of cystic echinococcosis and supports the use of a monitoring-only approach to inactive, uncomplicated cysts of the liver. It also confirms that serology plays only an ancillary role in the clinical management of these patients, compared to ultrasound and other imaging techniques. The implications of these findings for clinical management and natural history of cystic echinococcosis are discussed.
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