EchiNam: multicenter retrospective study on the experience, challenges, and pitfalls in the diagnosis and treatment of alveolar echinococcosis in Belgium.

Abstract

Objectives: The aim of this retrospective study was to collect epidemiological, clinical, laboratory, imaging, management, and follow-up data on cases of alveolar echinococcosis (AE) diagnosed and/or followed up within the Namur Hospital Network (NHN) in order to gather information on the challenges, pitfalls, and overall experience in the diagnosis and treatment of AE.

Methods: EchiNam was a multicenter retrospective study. Patients diagnosed and/or treated for probable or confirmed AE in the NHN between 2002 and 2023 were included in the study. Patient selection was based on diagnosis codes, laboratory results, and albendazole (ABZ) dispensing.

Results: A total of 22 AE cases were retrieved, of which four were classified as probable and 18 as confirmed cases. Nine patients were either asymptomatic or had symptoms attributed to another disease. Clinical examination yielded pathologic findings in 10 patients. The median duration from the first AE-suggestive laboratory abnormalities to diagnosis was 176 days, and the median duration from the first AE-related imaging abnormalities to diagnosis was 133 days. Overall, 12 patients underwent surgical resection, with only four achieving complete lesion resection. Nine patients experienced ABZ-related adverse effects, with temporary ABZ discontinuation in five.

Conclusion: Due to various factors such as a long incubation period and a lack of awareness among Belgian physicians, AE is often diagnosed at advanced disease stages. Treatment then becomes more complex or even suboptimal, resulting in prolonged therapy, higher risk of adverse effects, significantly impaired quality of life, poor prognosis, and higher mortality rates. Measures should be taken to achieve early diagnosis in endemic areas.