Novel mechanism of hepatobiliary system damage and immunoglobulin G4 elevation caused by Clonorchis sinensis infection

Table 1 Review of case reports of Clonorchis sinensis

Country	Ref.	Age	Sex	Food	History
China	Wang et al[37], 2019	52	Male	Freshwater fish	None
China	Hao et al[38], 2016	48	Male	None	None
China	Liu et al[39], 2019	49	Male	Freshwater fish	-
China	Liu et al[39], 2019	40	Female	Freshwater fish	-
South Korea	Oh et al[40], 2014	68	Male	Freshwater fish	Gastric cancer and inguinal hernia
South Korea	Choi et al[41], 2015	53	Male	Freshwater fish	Chronic hepatitis B
South Korea	Lee et al[42], 2003	54	Male	Freshwater fish	None
South Korea	Lim et al[43], 2011	26	Male	Freshwater fish	-
Japan	Fujiya et al[44], 2016	60	Male	None	-
United States	Papachristou et al[45], 2005	35	Male	None	-
China	Bian et al[46], 2001	35	Female	None	-
Symptom(s)	Ultrasound	CT	MRCP	ERCP	Pathology
Severe abdominal pain in the right upper abdomen, acute shock	-	Cholecystitis, stone-like material in the gallbladder	Cholecystitis, stone-like material in the gallbladder	-	-
Jaundice	-	Cholecystitis, mild dilation of the intrahepatic duct	Cholecystitis, mild dilation of the intrahepatic duct	-	Liver biopsy: Eosinophil infiltration, obvious bile duct hyperplasia, liver cell degeneration, bile duct capillary blockage, chronic G3S1 hepatitis
Severe abdominal pain in the right upper abdomen	-	-	Bile duct stones, obvious spread of intrahepatic ducts	-	-
Jaundice, Severe abdominal pain	-	Bile duct obstruction, dilatation of the intrahepatic bile duct, bile duct stones, gallbladder stones	-	-	-
Fever, Severe abdominal pain in the right upper abdomen	-	Gallbladder dilation, thickening of the wall, fluid around the gallbladder, mild dilation of the extrahepatic bile duct	Gallbladder dilation, fluid around the gallbladder, mild dilation of the extrahepatic bile duct	-	Pathological examination of the gallbladder: Severe inflammatory mucosa and parasite eggs
Blood in stool, abdominal pain	-	A 4.3 cm heterogeneous solid and cystic mass in the distal pancreas	Multiple cystic tumors in the tail of the pancreas	-	-
Erythema rash	Mild splenomegaly	-	-	-	Lung biopsy: Microscopic examination of lung tissue shows infiltration of eosinophils
Anorexia, fatigue and weight loss	-	Mild dilation of intrahepatic bile duct	Slight dilation of bile ducts with irregular wall and depression	Edema and bulging of the duodenal papilla	Pathological examination of the duodenal papilla: Chronic active inflammation with many eosinophils in the mucosal layer
Jaundice, abdominal pain	-	Gallstone in the common bile duct, gallbladder stone, thrombus in the main hilar branch of the hilum, completely occluded in the left hilar branch	-	-	-
Darkened urine, fatigue, weight loss	-	Soft tissue masses in the hilum, dilation of intrahepatic and extrahepatic ducts, ascites	-	Irregular dilation of intrahepatic and extrahepatic ducts	-
Upper abdominal discomfort, nausea, anorexia	Cholecystitis, common bile duct obstruction	-	-	-	-
EO	IgE	ALT (U/L)	TBIL	Diagnosis	Treatment
15.1%	-	-	230.3 μmol/ L	Laparotomy, bile	Praziquantel
50%	-	211.9	229.7 μmol/ L	Stool	Praziquantel
6.50%	-	236	128.8 μmol/ L	Common bile duct exploration by laparoscopy	Albendazole
15.40%	-	399	129.2 μmol/ L	Common bile duct exploration by laparoscopy	Albendazole
-	-	94	2.8 mg/dL	Laparotomy, gallbladder	Praziquantel
-	-	27		Laparotomy, pancreas
35%	1020 IL/ML	-		Stool	Praziquantel
18.30%	-	248	11.3 mg/dL	Bile	Praziquantel
154/μL	-	171		Bile	Praziquantel
4%	-	135	4.0 mg/dL	Biliary biopsy	Praziquantel
-	-	-	-	Biliary biopsy	Praziquantel

CT: Computed tomography; MRCP: Magnetic resonance cholangiopancreatography; ERCP: Endoscopic retrograde cholangiopancreatography; IgE: Immunoglobulin E; ALT: Alanine aminotransferase; TBIL: Total bilirubin.