Soluble programmed death-1 (sPD-1) as predictor of early surgical outcomes of paediatric cystic echinococcosis.

AIMS: Following treatment, cystic echinococcosis (CE) exhibits a relatively high relapse rate. Here, we evaluated the value of soluble programmed death-1 (sPD-1), sPD-1 ligand (sPD-L1) and anti-recP29 antibody concentrations, as predictors of early surgical treatment outcomes in young CE-affected patients. METHODS AND RESULTS: This prospective study included 59 Tunisian children (177 plasmas), where CE was surgically treated and monitored for 3 post-operative years. Based on CE post-surgical development, patients were clustered into a 'No relapsed' CE (NRCE; n = 39) and a 'Relapsed' CE (RCE; n = 20) group. Plasma levels of sPD-1, sPD-L1 and anti-recP29 IgG were measured using ELISA. In the NRCE group, sPD-1, sPD-L1 and anti-recP29 IgG concentrations were significantly lower at D365 than at D30. By contrast, in the RCE group, no significant difference was observed between D0, D30 and D365. When considering individual variations, the probability to be 'relapse-free' was 67% and 73% when anti-recP29 IgG and sPD-L1 level, respectively, decreased between D30 and D365. The probability to be 'relapse-free' was 86% when the sPD-1 level decreased between D30 and D365 (P = .003; chi-square test). CONCLUSION: sPD-1 may be a useful biomaker for the early evaluation of surgical procedure efficacy in paediatric CE cases.

How to treat hepatic pulmonary fusion: case report with review of literature.

Introduction: Hepatic pulmonary fusion (HPF) occurring with right diaphragmatic hernia is rare. Some sporadic reports exist in the literature. It may range from just fibrovascular communication to complete parenchymal fusion which may be complex to divide.Patients and methods: We report a case of a 1-day old newborn male presented with respiratory distress relevant to a right diaphragmatic hernia.Results: The patient was operated after initial stabilization. During surgery, a 10-cm wide posterolateral defect was found. The herniated liver was only partially reducible because of HPF. This rare condition was treated by the division of the fusion and diaphragm repair using a vicryl patch.Conclusion: Through our case and a review of the literature, we will discuss the different alternatives in the treatment of HPF.