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Immunological Characteristics of Recurrent Echinococcosis-Induced Anaphylactic Shock
Anaphylactic shock represents a serious complication of echinococcosis as up to 4.6% of patients die as a result of its severity and improper handling. Once a definite diagnosis is made, effective treatments need to be immediately initiated. Here, we report the immunological characteristics and management of two patients with recurrent anaphylactic shock concurrent with the surgical removal of hydatid cysts. Both patients had systemic echinococcosis classified as cystic echinococcosis type 2 (CE2) with multiple, immature cysts (absence of calcification and necrosis). In addition, both patients had increased eosinophils and basophils before surgery, as well as elevated crude hydatid cyst fluid antigen (anti-EgCF) and hydatid cyst fluid native antigen B (anti-EgB) antibodies and high IgG levels. Although we cannot definitively predict which patients are at risk for cyst fluid leakage or anaphylactic shock at present, clinicians may consider taking precautions before surgery on encountering patients with a similar profile to prevent the occurrence of anaphylactic shock and the likelihood of a second incident. However, these observations need to be confirmed in further studies with a larger number of patients.
Author Notes
Financial support: This study is funded by National Natural Science Foundation, project number: 81460309, “Identification, purification and immunogenicity study of specific antigen of anaphylactic shock induced by echinococcosis.”
Authors' addresses: Jianrong Ye, Qin Zhang, Long Ma, and Hong Zheng, Department of Anesthesiology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, China, E-mails: yejianrong0@sina.com, zhangqin99999999@sina.com, malong951@sina.com, and zhenghong99999@sina.com.