Hypocholesterolemia in Patients with an Amebic Liver Abscess

BACKGROUND/AIMS: Many parasites induce changes in the lipid profiles of the host. Cholesterol increases the virulence of Entamoeba histolytica in animal models and in vitro culture. This study aimed to determine, in patients with an amebic liver abscess, the correlation between cholesterol and other features, such as the size and number of abscesses, standard hematological and serum chemistry profiles, liver tests, and duration of hospital stay. METHODS: A total of 108 patients with an amebic liver abscess and 140 clinically healthy volunteers were investigated. Cholesterol and triglycerides were measured in the sera. The data from medical observations and laboratory tests were obtained from the clinical records. RESULTS: A total of 93% of patients with an amebic liver abscess showed hypocholesterolemia not related to any of the studied parameters. Liver function tests correlated with the size of the abscess. The most severe cases of amebic liver disease or death were found in patients whose cholesterol levels continued to decrease despite receiving antiamebic treatment and hospital care. CONCLUSIONS: Our results show that the hypocholesterolemia observed in patients with an amebic liver abscess is not related to any of the clinical and laboratory features analyzed. This is the first study relating hypocholesterolemia to severity of hepatic amebiasis.

Absceso esplénico amebiano / Amebic splenetic abscess

La localización extraintestinal es una complicación temible de la amebiasis intestinal, con una elevada mortalidad, que oscila entre el 4 al 14 por ciento de los casos diagnosticados. La forma de presentación más común es el absceso hepático amebiano, y aunque se han reportado localizaciones pulmonares, peritoneales, y hasta cerebrales, la localización esplénica es extremadamente infrecuente. Se reporta un caso de amebiasis esplénica que evolucionó tórpidamente, a pesar del tratamiento específico con metronidazol desde su admisión al Departamento de Emergencia, y que fue intervenido quirúrgicamente al séptimo día, con evolución favorable después de la resección del bazo. Se realiza una revisión de la literatura actualizada sobre el tema(AU)

The extraintestinal location is a fearsome complication of the intestinal amebiasis, with a high mortality fluctuating between the 4 and the 14 percent of cases diagnosed. The commonest presentation way is the amebic hepatic abscess and although others have reported pulmonary, peritoneal and up to cerebral locations, the splenetic one is extremely infrequent. A case of splenetic amebiasis is reported which evolved in a torpid way despite the specific treatment with metronidazole from its admission to Emergence Department and that was operated on at seventh day with a favorable evolution after spleen resection. Authors made a review of the updated literature on this subject(AU)