02604nas a2200265   4500008004100000022004700041245010600088210006900194250001000263260001100273520181600284100001302100700001502113700001302128700001802141700001602159700002102175700001702196700001602213700002102229700001202250700001202262700001602274856004802290       2010                        Eng d  a1399-3062 (Electronic) 1398-2273 (Linking)00aRapidly progressive hepatic alveolar echinococcosis in an ABO-incompatible renal transplant recipient0 aRapidly progressive hepatic alveolar echinococcosis in an ABOinc  a40479  cOct 263 aM. Geyer, J. Wilpert, T. Wiech, C. Theilacker, M. Stubanus, A. Kramer-Zucker, K.-G. Fischer, O. Drognitz, A. Frydrychowicz, W. Kern, G. Walz, P. Pisarski. Rapidly progressive hepatic alveolar echinococcosis in an ABO-incompatible renal transplant recipient.Transpl Infect Dis 2010. All rights reserved Abstract: We report on the case of an ABO-incompatible renal re-transplant recipient maintained on an intensified immunosuppressive regimen for recurrent cellular rejection episodes and transplant glomerulopathy who presented with rapidly growing hepatic tumors, radiologically suggestive of hemangiosarcoma. Upon resection and pathological work-up, the lesions revealed alveolar echinococcosis, a rare but potentially life-threatening parasitosis. Usually infection with Echinococcus multilocularis remains asymptomatic for extended periods of time and can go unrecognized for years. In the case presented, we observed an atypically rapid growth pattern of E. multilocularis that might have been due to the extent of the immunosuppressive regimen, which included repetitive anti-CD20 treatments. Retrospectively performed serological studies with enzyme-linked immunosorbent assays known to provide high sensitivity and specificity for the detection of echinococcosis in the general population, yielded ambiguous results in our immunocompromised host, which could be, in part, explained by B-cell depletion and its effects on antibody production and indirect actions on cellular immunity. In conclusion, this is the first report to our knowledge of hepatic alveolar echinococcosis in a renal transplant recipient. This case documents an altered clinical course of the parasitosis and the challenge of serological diagnostic tools under an intensified regimen of immunosuppressive agents, including rituximab.1 aGeyer, M1 aWilpert, J1 aWiech, T1 aTheilacker, C1 aStubanus, M1 aKramer-Zucker, A1 aFischer, K G1 aDrognitz, O1 aFrydrychowicz, A1 aKern, W1 aWalz, G1 aPisarski, P  uhttps://www.notifylibrary.org/reference/577