Cerebral CT changes and pituitary-gonadal dysfunction in schistosomal hepatic fibrosis

ABSTRACT

Brain CT and estimation of basal serum luteinizing hormone, testosterone and prolactin were performed in thirty male patients with confirmed schistosomal hepatic fibrosis [SHF], aged 20-40 years and 15 matched controls. Brain scans showed overt mild cortical atrophy in 5 patients, internal hydrocephalus in one and normal brain scan in 24 cases. CT measures in the latter patients revealed significantly wider sulcal score than that of controls though still within normal ranges. Hormonal assays showed significant lowering of basal serum LH and testosterone in schistosonnal cases with and without cerebral atrophy while the basal serum prolactin level in these patients was not significantly increased. There were no significant differences in the studied hormones' levels in cases with and without cerebral atrophy. The present findings showed measurable cerebral neuroanatomical disturbances in patients with SHF without clinical neurological manifestations. Pathogenesis of these changes is still unknown. Moreover, the mechanism of hypogonadism in SHF may be a defect at the level of the hypothalamus and/or pituitary rather than primary gonadal failure