RESUMO
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.
Assuntos
Animais , Humanos , Masculino , Pessoa de Meia-Idade , Cirrose Hepática , Hepatopatias Parasitárias , Veia Porta , Esquistossomose mansoni , Cirrose Hepática/parasitologia , Cirrose Hepática/patologia , Cirrose Hepática , Hepatopatias Parasitárias/parasitologia , Hepatopatias Parasitárias/patologia , Hepatopatias Parasitárias , Imageamento por Ressonância Magnética , Veia Porta/parasitologia , Veia Porta/patologia , Veia Porta , Índice de Gravidade de Doença , Esquistossomose mansoni/complicações , Esquistossomose mansoni/patologia , Esquistossomose mansoniAssuntos
Adulto , Animais , Humanos , Masculino , Neuroesquistossomose/parasitologia , Esquistossomose mansoni/diagnóstico , Doenças da Medula Espinal/parasitologia , Vértebras Cervicais/parasitologia , Vértebras Cervicais , Laminectomia , Imageamento por Ressonância Magnética , Neuroesquistossomose/diagnóstico , Neuroesquistossomose/tratamento farmacológico , Oxamniquine/uso terapêutico , Prednisolona/uso terapêutico , Schistosoma mansoni , Esquistossomose mansoni/tratamento farmacológico , Esquistossomicidas/uso terapêutico , Doenças da Medula Espinal/diagnóstico , Doenças da Medula Espinal/tratamento farmacológicoRESUMO
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