ABSTRACT
Eighteen children, eleven females and seven males, with hepatosplenic mansonic schistosomiasis, underwent splenectomy, ligature of the left gastric vein and autoimplantation of splenic tissue in the great omentum. Their blood lymphocyte subsets: B; T; T helper (CD4); and T supressor (CD8) were analyzed. The patients were divided into two groups. 1 - represented by ten patients, six of whom had the lymphocyte subsets analysis performed before and three months after surgery. 2 - represented by eight patients who had undergone similar treatment with follow up greater than 12 months. The lymphocyte sbsets were recognized by monoclonal antibodies. Apart from B, all lymphocytes were in significant lower numbers before surgical treatment. At early follow up there was a significant increase in all lymphocyte subsets. There was a significant decrease of the ratio CD4/CD8 due to a greater increase in the expression of CD8. Lymphocyte counts from the second group were no different from the first group at early follow up. The isolated effect of autotransplantation of splenic tissue could not be demonstrated. These patients have had no increase in the rate of infections after surgery and none have developed overwhelming post-splenectomy septicemia.
Subject(s)
Humans , Male , Female , Child , Adolescent , Liver Diseases, Parasitic/surgery , Schistosomiasis mansoni/surgery , Splenectomy , Splenic Diseases/surgery , Transplantation, Autologous , Liver Diseases, Parasitic/complications , Schistosomiasis/complications , Treatment OutcomeABSTRACT
Sete crianças, entre 10 e 16 anos, portadoras de esquistossomose mansônica na forma hepato-esplênica, foram avaliadas quanto ao número de leucócitos, linfócitos totais, linfócitos B, linfócitos T, linfócitos T "helper" (CD4), linfócitos T "supressor" (CD8) e relaçäo CD4/CD8. As avaliaçöes foram por técnicas das micropérolas imunes (Immunobead-BIORAD) utilizando-se anticorpos monoclonais. Nas crianças esquistossomóticas foi evidenciado diminuiçäo significativa de leucócitos, diminuiçäo näo significativa de linfócitos totais, linfócitos T e linfócitos T "helper e T "supressor". O número de linfóciots B foi maior do que na populaçäo normal. A relaçäo linfócitos T/lilnfócitos B foi significativamente menor nas crianças esquistossomóticas (3,75+-0,90 versus 6,65+-3,15). A relaçäo CD4/CD8 foi similar a da populaçäo normal
Subject(s)
Humans , Male , Female , Child , Adolescent , B-Lymphocytes , Lymphocyte Count , Schistosomiasis mansoni/immunology , T-Lymphocytes , T-Lymphocytes, Regulatory , LeukocytesABSTRACT
Quinze crinças portadoras de esquistossomose manônica na forma hepato esplênica foram submetidas a esplenectomia, ligadura da veia gástrica esquerda, associada ao auto implante esplênico. Esses pacientes seguiram protocolo de antibioticoterapia prolongada e foram avaliados quanto a incidência de infecçäo no pós-operatório imediato. A frequência de infecçäo de ferida operatória, 6,66 por cento, encontrada na presente investigaçäo é inferior a de adultos com a mesma patologia submetidos a diversos tipos de cirurgias, com e sem antibioticoterapia prolongada. Os achados parecem indicar que o uso prolongado de antibióticos, provalvelmente, contribuiu para diminuir a incidência de infecçäo no pós-operatório imediado das crianças