• L Jacquel, B Hoellinger, G Marzolf, A Stab, and A Guffroy.
• Service de médecine interne et d'immunologie clinique, Centre national de référence pour les maladies auto-immunes et systémiques (CNR RESO), Centre de compétences pour les déficits immunitaires primitifs, hôpitaux universitaires de Strasbourg, Strasbourg, France. Electronic address: lea.jacquel@chru-strasbourg.fr.
• Rev Med Interne. 2024 Jun 1; 45 (6): 382386382-386.

IntroductionAlveolar echinococcosis is an endemic parasitic disease prevalent in certain cold regions of the Northern Hemisphere, including Eastern France, Switzerland, Germany, Canada, and the United States. Widely underdiagnosed, it is associated with infection by Echinococcus multilocularis, a small tapeworm belonging to the cestode class, capable of causing multi-systemic involvement, particularly in elderly or immunocompromised patients.Case ReportWe present the case of an 82-year-old patient, immunocompromised due to prolonged corticosteroid therapy and treatment with dupilumab. She was referred to our department for a diagnostic assessment of atypical hepatic and pulmonary lesions, initially suspected of tuberculosis or an IgG4-related disease. The hypothesis of alveolar echinococcosis caused by E. multilocularis was eventually considered based on a set of arguments, further confirmed by molecular diagnosis. We discuss the role of dupilumab in the systemic evolution and atypical presentation of the disease, through the induction of a specific immunosuppression.ConclusionAlveolar echinococcosis should be systematically considered in case of systemic disease with prominent hepatic and pulmonary involvement, especially in immunocompromised patients.Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.

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