Pancreatic involvement in fatal human leptospirosis: clinical and histopathological features
Rev. Inst. Med. Trop. Säo Paulo
;
45(6): 307-313, Nov.-Dec. 2003. ilus, tab
Artigo
em Inglês
| LILACS
| ID: lil-353980
ABSTRACT
Hyperamylasemia has been reported in more than 65 percent of patients with severe leptospirosis, and the true diagnosis of acute pancreatitis is complicated by the fact that renal failure can increase serum amylase levels. Based on these data we retrospectively analyzed the clinical and histopathological features of pancreas involvement in 13 cases of fatal human leptospirosis. The most common signs and symptoms presented at admission were fever, chills, vomiting, myalgia, dehydratation, abdominal pain and diarrhea. Trombocytopenia was evident in 11 patients. Mild increased of AST and ALT levels was seen in 9 patients. Hyperamylasemia was recorded in every patient in whom it was measured, with values above 180 IU/L (3 cases). All patients presented acute renal failure and five have been submitted to dialytic treatment. The main cause of death was acute respiratory failure due to pulmonary hemorrhage. Pancreas fragments were collected for histological study and fat necrosis was the criterion used to classify acute pancreatitis. Histological pancreatic findings were edema, mild inflammatory infiltrate of lymphocytes, hemorrhage, congestion, fat necrosis and calcification. All the patients infected with severe form of leptospirosis who develop abdominal pain should raise the suspect of pancreatic involvement.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Pancreatite
/
Injúria Renal Aguda
/
Leptospirose
Tipo de estudo:
Estudo observacional
Limite:
Adulto
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Rev. Inst. Med. Trop. Säo Paulo
Assunto da revista:
Medicina Tropical
Ano de publicação:
2003
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Universidade Federal do Ceará/BR
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