Rheumatology: Current Research
Open Access

Abstract

Shocking Liver

Shaye Kivity, Menachem Ben-Haim, Larisa Guranda and David Olchovsky

Introduction: In rare cases, anaphylaxis may be the explanation for recurrent loss of consciousness. Common causes of anaphylaxis are drugs, food or food additives, chemicals such as latex, systemic mastocytosis, parasites and idiopathic anaphylaxis.

Case: A 63 year old man of Iraqi descendant was hospitalized due to unexplained recurrent loss of consciousness, which responded well to rapid fluid administration. Eosinophils and triptase levels-90 minutes after an episode, were both elevated. An abdomen computed tomographic scan revealed a multilocular hepatic cyst (12 X12cm) with filling defects in the portal vein and two large liver infarcts, caused by embolized daughter cysts. Treatment with hydrocortisone and albendazole was initiated, and the patient underwent surgical intervention.

Summary: Our patient presented with a fluid-responsive shock that was subsequently diagnosed as anaphylaxis due to embolized echinococcal cysts.

Conclusions: Anaphylactic shock can be caused due to an immunological reaction to parasites such echinococcal cysts, even when a latency period of up to 50 years from infection exists.