Opisthorchiasis history and symptoms: Difference between revisions
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{{Opisthorchiasis}} | {{Opisthorchiasis}} | ||
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==History and Symptoms== | |||
Most infections are asymptomatic. In mild cases, manifestations include [[dyspepsia]], abdominal pain, [[diarrhea]] or [[constipation]]. With infections of longer duration, the symptoms can be more severe, and hepatomegaly and malnutrition may be present. In rare cases, cholangitis, cholecystitis, and chlolangiocarcinoma may develop. In addition, infections due to O. felineus may present an acute phase resembling Katayama [[fever]] ([[schistosomiasis]]), with fever, facial edema, [[lymphadenopathy]], arthralgias, rash, and [[eosinophilia]]. Chronic forms of O. felineus infections present the same manifestations as O. viverrini, with in addition involvement of the pancreatic ducts. | |||
[[File:Symptoms of Raw fish infection.svg.png|thumb|center|Symptoms of opisthorchiasis/[[clonorchiasis]].]] | |||
Symptoms of opisthorchiasis (caused by ''Opisthorchis'' spp.) are indistinguishable from [[clonorchiasis]] (caused by ''[[Clonorchis sinensis]]''),<ref name="Kingl 2001"/> so the disease should be referred as clonorchiasis.<ref name="Kingl 2001"/> | |||
About 80% of infected people have no symptoms, though they can have [[eosinophilia]].<ref name="Muller 2002"/> This is when the infection is weak and there are less than 1000 eggs in one gram in feces.<ref name="Muller 2002"/> | |||
When there are 10.000-30.000 eggs in one gram of feces, then the infection is heavy.<ref name="Muller 2002"/> Symptoms of heavier infections with ''Opisthorchis viverrini'' may include: [[diarrhoea]], pain in [[epigastric]] and pain in the upper right quadrant, lack of appetite ([[Anorexia (symptom)|anorexia]]), [[Fatigue (medical)|fatigue]], yellowing of the eyes and skin ([[jaundice]]) and mild [[fever]].<ref name="Muller 2002"/> | |||
These parasites are long-lived and cause heavy chronic infections may led to accumulation of fluid in legs ([[edema]]) and in the [[peritoneal cavity]] ([[ascites]]),<ref name="Muller 2002"/> enlarged non-functional [[gall-bladder]]<ref name="Muller 2002"/> and also [[cholangitis]],<ref name="Young 2010"/> which can lead to periductal [[fibrosis]], [[cholecystitis]] and [[cholelithiasis]], obstructive [[jaundice]], [[hepatomegaly]] and/or fibrosis of the periportal system.<ref name="Young 2010"/> | |||
Importantly, both experimental and epidemiological evidence strongly implicates ''Opisthorchis viverrini'' infections in the etiology of a malignant cancer of the bile ducts ([[cholangiocarcinoma]]) in humans which has a very poor prognosis.<ref name="Young 2010"/> Indeed, ''Clonorchis sinensis'' and ''Opisthorchis viverrini'' are both categorized by the [[International Agency for Research on Cancer]] (IARC) as [[List of IARC Group 1 carcinogens|Group 1 carcinogens]].<ref name="Young 2010"/> | |||
In humans, the onset of cholangiocarcinoma occurs with chronic opisthorchiasis, associated with hepatobiliary damage, inflammation, periductal fibrosis and/or cellular responses to antigens from the infecting fluke.<ref name="Young 2010"/> These conditions predispose to cholangiocarcinoma, possibly through an enhanced susceptibility of [[DNA]] to damage by [[carcinogen]]s.<ref name="Young 2010"/> Chronic hepatobiliary damage is reported to be multi-factorial and considered to arise from a continued mechanical irritation of the [[epithelium]] by the flukes present, particularly via their suckers, metabolites and excreted/secreted [[antigen]]s as well as immunopathological processes.<ref name="Young 2010"/> In regions where ''Opisthorchis viverrini'' is highly endemic, the incidence of cholangiocarcinoma is unprecedented.<ref name="Young 2010"/> For instance, cholangiocarcinomas represent 15% of primary liver cancer worldwide, but in Thailand's Khon Kaen region, this figure escalates to 90%, the highest recorded incidence of this cancer in the world.<ref name="Young 2010"/> Of all cancers worldwide from 2002, 0.02% were cholangiocarcinoma caused by ''Opisthorchis viverrini''.<ref name="Stripa 2007"/> | |||
The cancer of the bile ducts caused by opisthorchiasis occur in the ages 25–44 years in Thailand.<ref name="WHO 1995"/> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Needs | [[Category:Needs overview]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
Revision as of 19:43, 26 November 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
History and Symptoms
Most infections are asymptomatic. In mild cases, manifestations include dyspepsia, abdominal pain, diarrhea or constipation. With infections of longer duration, the symptoms can be more severe, and hepatomegaly and malnutrition may be present. In rare cases, cholangitis, cholecystitis, and chlolangiocarcinoma may develop. In addition, infections due to O. felineus may present an acute phase resembling Katayama fever (schistosomiasis), with fever, facial edema, lymphadenopathy, arthralgias, rash, and eosinophilia. Chronic forms of O. felineus infections present the same manifestations as O. viverrini, with in addition involvement of the pancreatic ducts.
Symptoms of opisthorchiasis (caused by Opisthorchis spp.) are indistinguishable from clonorchiasis (caused by Clonorchis sinensis),[1] so the disease should be referred as clonorchiasis.[1]
About 80% of infected people have no symptoms, though they can have eosinophilia.[2] This is when the infection is weak and there are less than 1000 eggs in one gram in feces.[2]
When there are 10.000-30.000 eggs in one gram of feces, then the infection is heavy.[2] Symptoms of heavier infections with Opisthorchis viverrini may include: diarrhoea, pain in epigastric and pain in the upper right quadrant, lack of appetite (anorexia), fatigue, yellowing of the eyes and skin (jaundice) and mild fever.[2]
These parasites are long-lived and cause heavy chronic infections may led to accumulation of fluid in legs (edema) and in the peritoneal cavity (ascites),[2] enlarged non-functional gall-bladder[2] and also cholangitis,[3] which can lead to periductal fibrosis, cholecystitis and cholelithiasis, obstructive jaundice, hepatomegaly and/or fibrosis of the periportal system.[3]
Importantly, both experimental and epidemiological evidence strongly implicates Opisthorchis viverrini infections in the etiology of a malignant cancer of the bile ducts (cholangiocarcinoma) in humans which has a very poor prognosis.[3] Indeed, Clonorchis sinensis and Opisthorchis viverrini are both categorized by the International Agency for Research on Cancer (IARC) as Group 1 carcinogens.[3]
In humans, the onset of cholangiocarcinoma occurs with chronic opisthorchiasis, associated with hepatobiliary damage, inflammation, periductal fibrosis and/or cellular responses to antigens from the infecting fluke.[3] These conditions predispose to cholangiocarcinoma, possibly through an enhanced susceptibility of DNA to damage by carcinogens.[3] Chronic hepatobiliary damage is reported to be multi-factorial and considered to arise from a continued mechanical irritation of the epithelium by the flukes present, particularly via their suckers, metabolites and excreted/secreted antigens as well as immunopathological processes.[3] In regions where Opisthorchis viverrini is highly endemic, the incidence of cholangiocarcinoma is unprecedented.[3] For instance, cholangiocarcinomas represent 15% of primary liver cancer worldwide, but in Thailand's Khon Kaen region, this figure escalates to 90%, the highest recorded incidence of this cancer in the world.[3] Of all cancers worldwide from 2002, 0.02% were cholangiocarcinoma caused by Opisthorchis viverrini.[4]
The cancer of the bile ducts caused by opisthorchiasis occur in the ages 25–44 years in Thailand.[5]