ABSTRACT
Abdominal ultrasound (US) has been widely used in the evaluation of patients with schistosomiasis mansoni. It represents an important indirect method of diagnosis and classification of the disease, and it has also been used as a tool in the evaluation of therapeutic response and regression of fibrosis. We describe the case of a man in whom US showed solid evidence of schistosomal periportal fibrosis and magnetic resonance imaging revealed that periportal signal alteration corresponded to adipose tissue which entered the liver togheter with the portal vein.
Subject(s)
Animals , Humans , Male , Middle Aged , Liver Cirrhosis , Liver Diseases, Parasitic , Portal Vein , Schistosomiasis mansoni , Liver Cirrhosis/parasitology , Liver Cirrhosis/pathology , Liver Cirrhosis , Liver Diseases, Parasitic/parasitology , Liver Diseases, Parasitic/pathology , Liver Diseases, Parasitic , Magnetic Resonance Imaging , Portal Vein/parasitology , Portal Vein/pathology , Portal Vein , Severity of Illness Index , Schistosomiasis mansoni/complications , Schistosomiasis mansoni/pathology , Schistosomiasis mansoniSubject(s)
Adult , Animals , Humans , Male , Neuroschistosomiasis/parasitology , Schistosomiasis mansoni/diagnosis , Spinal Cord Diseases/parasitology , Cervical Vertebrae/parasitology , Cervical Vertebrae , Laminectomy , Magnetic Resonance Imaging , Neuroschistosomiasis/diagnosis , Neuroschistosomiasis/drug therapy , Oxamniquine/therapeutic use , Prednisolone/therapeutic use , Schistosoma mansoni , Schistosomiasis mansoni/drug therapy , Schistosomicides/therapeutic use , Spinal Cord Diseases/diagnosis , Spinal Cord Diseases/drug therapyABSTRACT
Schistosoma mansoni infection is likely to be responsible for a significant proportion of cases of myelopathy occurring in areas where schistosomiasis is endemic. The aim of this study is to describe the clinical, laboratory and therapeutic data of 23 patients with schistosomal myeloradiculopathy. The medical records of 23 patients with schistosomal myelopathy admitted to two general hospitals of Belo Horizonte (MG), in Brazil, from 1995 to 1999, were reviewed retrospectively. Seventeen patients were male (74 percent). The mean age for the whole group was 27 years. Lower limb weakness and associated lumbar and/or lower limb pain were reported by 20 patients (87 percent), and 16 (70 percent) were unable to walk. All individuals presented urinary retention and 19 (83 percent) complained of intestinal dysfunction. The treatment was based on the association of antischistosomal drugs and corticosteroids. Five patients (22 percent) presented a full response to treatment, 13 (57 percent) partial response without functional limitations and 4 (17 percent) partial improvement with limitations or no response. Three out of the 4 patients who stopped steroids before 45 days of treatment developed recurrence of the symptoms and signs of myelopathy. Our cases demonstrate the severe presentation of the disease and the data disclosed here suggest that treatment with steroids should be kept for months after clinical improvement