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1.
Ultrasound Med Biol ; 47(5): 1235-1243, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33618959

RESUMO

In patients with Mansoni schistosomiasis, it is fundamental to evaluate the disease morbidity, which is reflected by the severity of periportal fibrosis (PPF) and parameters of portal hypertension, as analyzed by ultrasonography (US). This study aimed to evaluate the morbidity of schistosomiasis by hepatic and splenic point shear-wave elastography (pSWE) and relate this to US parameters. The PPF pattern, the diameter of the portal and splenic veins and the size of the spleen were evaluated by US. Then, liver and spleen pSWEs were assessed in 74 patients using the same equipment. As the PPF pattern progressed, the splenic pSWE values significantly increased. Significant correlations between splenic pSWE, the longitudinal and transverse lengths of the spleen and the diameters of the portal and splenic veins were observed. These findings, however, were not observed through hepatic pSWE. In conclusion, the splenic pSWE has the potential for assessing morbidity in schistosomiasis mansoni.


Assuntos
Técnicas de Imagem por Elasticidade , Hepatopatias Parasitárias/diagnóstico por imagem , Esquistossomose mansoni/diagnóstico por imagem , Esplenopatias/diagnóstico por imagem , Esplenopatias/parasitologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Índice de Gravidade de Doença
2.
Trop Doct ; 50(3): 216-221, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32356671

RESUMO

Repeated praziquantel treatment for schistosomiasis is an effective method to reduce disease burden. Ultrasonographic methods were used to assess the severity of schistosoma mansoni-related liver disease and demonstrate improvement following treatment. We compared data from 733 children in 2010 and 972 children in 2018 to determine the effect of repeated praziquantel treatment on prevalence of liver disease. Three age groups were compared across three liver disease classifications (normal, mild, severe). From 2010 to 2018, there was a significant reduction in prevalence of severe liver disease in all age groups (P = 0.03 for 5-10 years, P < 0.001 for 11-15 years and 16-20 years). In both male and female students, the proportion having a normal liver significantly increased (P < 0.001) from 2010 to 2018, in the 11-15-year-olds and 16-20-year-olds, demonstrating that liver disease significantly reduced in these age groups. This study demonstrates a reduction in schistosomiasis-related morbidity with repeated praziquantel treatment.


Assuntos
Anti-Helmínticos/administração & dosagem , Hepatopatias Parasitárias/prevenção & controle , Praziquantel/administração & dosagem , Esquistossomose/prevenção & controle , Adolescente , Animais , Criança , Pré-Escolar , Feminino , Humanos , Hepatopatias Parasitárias/diagnóstico por imagem , Hepatopatias Parasitárias/epidemiologia , Hepatopatias Parasitárias/patologia , Masculino , Prevalência , População Rural , Schistosoma mansoni/efeitos dos fármacos , Esquistossomose/diagnóstico por imagem , Esquistossomose/epidemiologia , Esquistossomose/patologia , Ultrassonografia , Adulto Jovem , Zâmbia/epidemiologia
3.
Arq. bras. cardiol ; 113(5): 915-922, Nov. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1055038

RESUMO

Abstract Background: Hepatopulmonary syndrome (HPS), found in cirrhotic patients, has been little studied in hepatosplenic schistosomiasis (HSS) and includes the occurrence of intrapulmonary vascular dilatations (IPVD). Contrast transesophageal echocardiography (cTEE) with microbubbles is more sensitive than contrast transthoracic echocardiography (cTTE) with microbubbles in the detection of IPVD in cirrhosis. Objective: To assess the performance of the cTEE, compared with that of cTTE, in detecting IPVD for the diagnosis of HPS in patients with HSS. Methods: cTEE and cTTE for investigation of IPVD and laboratory tests were performed in 22 patients with HSS. Agitated saline solution was injected in peripheral vein during the cTEE and cTTE procedures. Late appearance of the microbubbles in the left chambers indicated the presence of IPVD. Results of the two methods were compared by the Student's t-test and the chi-square test (p < 0.05). Results: cTEE was performed in all patients without complications. Three patients were excluded due to the presence of patent foramen ovale (PFO). The presence of IPVD was confirmed in 13 (68%) of 19 patients according to the cTEE and in only six (32%, p < 0.01) according to the cTTE. No significant differences in clinical or laboratory data were found between the groups with and without IPVD, including the alveolar-arterial gradient. The diagnosis of HPS (presence of IPVD with changes in the arterial blood gas analysis) was made in five patients by the cTEE and in only one by the cTTE (p = 0.09). Conclusion: In HSS patients, cTEE was safe and superior to cTTE in detecting IPVD and allowed the exclusion of PFO.


Resumo Fundamento: A síndrome hepatopulmonar (SHP), presente em pacientes cirróticos, é pouco estudada na esquistossomose hepatoesplênica (EHE) e inclui a ocorrência de dilatações vasculares intrapulmonares (DVP). O ecocardiograma transesofágico com contraste (ETEc) de microbolhas é mais sensível que o ecocardiograma transtorácico com contraste (ETTc) de microbolhas na identificação de DVP na cirrose. Objetivo: Avaliar o desempenho do ETEc comparado ao ETTc na identificação de DVP para diagnóstico de SHP em pacientes com EHE. Métodos: Incluímos 22 pacientes com EHE submetidos a ETEc e ETTc para pesquisa de DVP, além de exames laboratoriais. Os ETEc e ETTc foram realizados empregando-se solução salina agitada, injetada em veia periférica. A visualização tardia das microbolhas em câmaras esquerdas indicava presença de DVP. Os resultados foram comparados entre os dois métodos pelos testes t de Stu dent e qui-quadrado (significância p < 0,05). Resultados: Todos os 22 pacientes realizaram ETEc sem intercorrências. Foram excluídos três pela presença de forame oval patente (FOP), e a análise final foi realizada nos outros 19. A DVP esteve presente ao ETEc em 13 pacientes (68%) e em apenas seis ao ETTc (32%, p < 0,01). Não houve diferenças significativas nos dados clínicos e laboratoriais entre os grupos com e sem DVP, incluindo a diferença alveoloarterial de oxigênio. O diagnóstico de SHP (presença de DVP com alterações gasométricas) ocorreu em cinco pacientes pelo ETEc e em apenas um pelo ETTc (p = 0,09). Conclusão: Em pacientes com EHE, o ETEc foi seguro e superior ao ETTc na detecção de DVP não identificada ao ETTc, o que possibilitou adicionalmente excluir FOP.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Esquistossomose/diagnóstico por imagem , Esplenopatias/diagnóstico por imagem , Ecocardiografia/métodos , Ecocardiografia Transesofagiana/métodos , Dilatação Patológica/diagnóstico por imagem , Hepatopatias Parasitárias/diagnóstico por imagem , Sensibilidade e Especificidade , Meios de Contraste , Síndrome Hepatopulmonar/diagnóstico , Síndrome Hepatopulmonar/diagnóstico por imagem , Microbolhas , Forame Oval Patente/diagnóstico
4.
Arq Bras Cardiol ; 113(5): 915-922, 2019 11.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31596323

RESUMO

BACKGROUND: Hepatopulmonary syndrome (HPS), found in cirrhotic patients, has been little studied in hepatosplenic schistosomiasis (HSS) and includes the occurrence of intrapulmonary vascular dilatations (IPVD). Contrast transesophageal echocardiography (cTEE) with microbubbles is more sensitive than contrast transthoracic echocardiography (cTTE) with microbubbles in the detection of IPVD in cirrhosis. OBJECTIVE: To assess the performance of the cTEE, compared with that of cTTE, in detecting IPVD for the diagnosis of HPS in patients with HSS. METHODS: cTEE and cTTE for investigation of IPVD and laboratory tests were performed in 22 patients with HSS. Agitated saline solution was injected in peripheral vein during the cTEE and cTTE procedures. Late appearance of the microbubbles in the left chambers indicated the presence of IPVD. Results of the two methods were compared by the Student's t-test and the chi-square test (p < 0.05). RESULTS: cTEE was performed in all patients without complications. Three patients were excluded due to the presence of patent foramen ovale (PFO). The presence of IPVD was confirmed in 13 (68%) of 19 patients according to the cTEE and in only six (32%, p < 0.01) according to the cTTE. No significant differences in clinical or laboratory data were found between the groups with and without IPVD, including the alveolar-arterial gradient. The diagnosis of HPS (presence of IPVD with changes in the arterial blood gas analysis) was made in five patients by the cTEE and in only one by the cTTE (p = 0.09). CONCLUSION: In HSS patients, cTEE was safe and superior to cTTE in detecting IPVD and allowed the exclusion of PFO.


Assuntos
Dilatação Patológica/diagnóstico por imagem , Ecocardiografia Transesofagiana/métodos , Ecocardiografia/métodos , Hepatopatias Parasitárias/diagnóstico por imagem , Esquistossomose/diagnóstico por imagem , Esplenopatias/diagnóstico por imagem , Adulto , Idoso , Meios de Contraste , Feminino , Forame Oval Patente/diagnóstico , Síndrome Hepatopulmonar/diagnóstico , Síndrome Hepatopulmonar/diagnóstico por imagem , Humanos , Masculino , Microbolhas , Pessoa de Meia-Idade , Sensibilidade e Especificidade
5.
Intern Med ; 58(18): 2737-2741, 2019 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-31178505

RESUMO

A 37-year-old woman presented to our hospital with mild abdominal pain experienced for 2 months and hepatic nodules in segments 3 and 8. Peripheral blood eosinophilia was observed, and toxocariasis was serologically diagnosed. Seventeen days after the first imaging evaluation, a new lesion was found in segment 9 of the right lung, which was contiguous through the diaphragm to the hepatic nodule in segment 8. After treatment with albendazole, the liver and lung nodules disappeared. We suspect that larvae had directly invaded the lung from the liver, through the diaphragm.


Assuntos
Larva Migrans Visceral/diagnóstico , Hepatopatias Parasitárias/diagnóstico por imagem , Pneumopatias Parasitárias/diagnóstico por imagem , Dor Abdominal , Adulto , Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêutico , Antivirais/uso terapêutico , Diafragma , Eosinofilia , Feminino , Hepatite C/complicações , Hepatite C/tratamento farmacológico , Humanos , Larva Migrans Visceral/complicações , Larva Migrans Visceral/tratamento farmacológico , Hepatopatias Parasitárias/complicações , Hepatopatias Parasitárias/tratamento farmacológico , Pneumopatias Parasitárias/complicações , Imageamento por Ressonância Magnética , Toxocaríase/complicações , Toxocaríase/diagnóstico , Toxocaríase/tratamento farmacológico
6.
Zhonghua Bing Li Xue Za Zhi ; 47(9): 710-713, 2018 Sep 08.
Artigo em Chinês | MEDLINE | ID: mdl-30220127

RESUMO

Objective: To investigate the clinical, radiological and pathological features of visceral parasitic migration of the liver. Methods: Seven cases of visceral parasitic migration of liver were identified at the Affiliated Drum Tower Hospital of Medical School of Nanjing University from January 2008 to July 2017. Clinical data, enhanced CT image and pathological features were analyzed, combining with literature review. Results: There were 5 male and 2 female patients. Five patients presented with abdominal pain or discomfort as the first symptom. Two patients were admitted to the hospital for physical examination with liver nodule. Blood eosinophils were mildly to moderately increased in 4 cases. Enhanced CT showed the liver irregular beaded nodules that showed no significant enhancement of arterial phase. Mild enhancement of round lesions (ring lesion) was seen in a few cases before surgery. By histopathology, the lesions showed central geographic necrosis, surrounded by epithelioid granuloma and inflammatory cell bands. A large number of eosinophils and scattered multinucleated giant cells were found, especially at the peripheral of the lesion. Charcot-Leyden crystals were present in all case and parasitic migrans was found in one case. Conclusions: Visceral parasitic migration of liver is a rare liver disease and is easily misdiagnosed as other benign or malignant liver tumors. Combining clinical data, enhanced CT images and pathological examination can improve the preoperative and postoperative diagnosis of the disease.


Assuntos
Hepatopatias Parasitárias/diagnóstico por imagem , Carcinoma Hepatocelular/diagnóstico por imagem , Diagnóstico Diferencial , Eosinófilos/patologia , Feminino , Granuloma/patologia , Humanos , Hepatopatias Parasitárias/patologia , Neoplasias Hepáticas/diagnóstico por imagem , Masculino
7.
J Gastrointest Surg ; 22(3): 550-552, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29340921

RESUMO

Paragonimiasis is a parasitic lung infection caused by lung flukes of the genus Paragonimus. Ectopic infection may occur but rarely involves the liver. Here, we report a case of hepatic paragonimiasis in a Chinese man who was initially suspected to have hepatocellular carcinoma. He had been previously diagnosed with chronic hepatitis B. No specific symptoms or abnormal blood test results were observed, except for a significant rise in serum alfa-fetoprotein. Magnetic resonance imaging revealed a 12-cm mass with inhomogeneous signal intensity at the left lobe of the liver. Laparoscopic left hemihepatectomy was performed. He was finally diagnosed as hepatic paragonimiasis upon pathological examination and antibody serology. The postoperative course was uneventful. He received a standard course of praziquantel and recovered well. Our case is unique in its tumor-like characteristic and protrudes the difficulty of differential diagnosis with both benignant and malignant hepatic diseases by imaging studies or non-specific symptoms. Hepatic paragonimiasis is unusual; however, it should be considered in the differential diagnosis of liver malignancy by clinicians.


Assuntos
Carcinoma Hepatocelular/diagnóstico , Hepatopatias Parasitárias/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico , Paragonimíase/diagnóstico por imagem , Adulto , Animais , Anti-Helmínticos/uso terapêutico , Diagnóstico Diferencial , Hepatectomia/métodos , Hepatite B Crônica/diagnóstico , Humanos , Laparoscopia , Hepatopatias Parasitárias/tratamento farmacológico , Hepatopatias Parasitárias/cirurgia , Imageamento por Ressonância Magnética , Masculino , Paragonimíase/tratamento farmacológico , Paragonimíase/cirurgia , Praziquantel/uso terapêutico
8.
Rev. Soc. Bras. Med. Trop ; 50(6): 805-811, Nov.-Dec. 2017. tab
Artigo em Inglês | LILACS | ID: biblio-897028

RESUMO

Abstract INTRODUCTION: Despite the advances of disease control programs, severe forms of schistosomiasis are prevalent. The prevalence of the disease in areas frequented by tourists urges for permanent prevention and control. The aim of this study was to describe the morbidity of schistosomiasis in the district of Antônio Pereira, Ouro Preto, Minas Gerais, Brazil. METHODS: The proportion of positives was defined by Kato-Katz coproscopy and urinary POC-CCA rapid test. Hepatosplenic form was diagnosed using abdominal ultrasound. RESULTS: Out of 180 participants,97 were examined by Kato-Katz, with 4 (4.1%) being positive. Thirty-four (22.1%) out of 154 were positive by POC-CCA. Five (2.8%) of 177 examined by ultrasound had hepatosplenic form. One of them had undergone splenectomy. One (0.6%)participant had myeloradiculopathy. CONCLUSIONS: Severe forms of schistosomiasis are still prevalent in low endemic areas and should be thoroughly investigated.


Assuntos
Humanos , Animais , Masculino , Feminino , Schistosoma mansoni/isolamento & purificação , Esplenopatias/epidemiologia , Esquistossomose mansoni/epidemiologia , Hepatopatias Parasitárias/epidemiologia , Esplenopatias/parasitologia , Esplenopatias/diagnóstico por imagem , Esquistossomose mansoni/diagnóstico , Prevalência , Estudos Transversais , Morbidade , Escolaridade , Fezes/parasitologia , Hepatopatias Parasitárias/parasitologia , Hepatopatias Parasitárias/diagnóstico por imagem , Antígenos de Helmintos/urina
10.
BMJ Case Rep ; 20172017 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-28814579

RESUMO

A 27-year-old man of Eritrean origin presented with persistent left-sided abdominal pain. Initial investigation showed signs of liver fibrosis, portal hypertension and splenomegaly. A diagnosis of hepatosplenic schistosomiasis was suspected on grounds of elevated total IgE, grey area antischistosomiasis antibodies and the high endemic status of his native country. However, repeated microscopy of faecal and urine samples, as well as rectal biopsies, failed to demonstrate schistosomal eggs. Finally, the diagnosis of hepatosplenic schistosomiasis was established through demonstration of a Schistosoma mansoni egg in a liver biopsy taken in an attempt to clarify the cause of the above findings. The patient had recently been treated for uncomplicated malaria. Lowered schistosomiasis worm/egg burden and hence reduced sensitivity of classic microscopy-based schistosomiasis testing was attributed to the antischistosomal activity of the antimalarial chemotherapy.


Assuntos
Hepatopatias Parasitárias/diagnóstico , Esquistossomose mansoni/diagnóstico , Esplenopatias/diagnóstico , Dor Abdominal/etiologia , Adulto , Animais , Dinamarca , Eritreia/etnologia , Humanos , Hepatopatias Parasitárias/complicações , Hepatopatias Parasitárias/diagnóstico por imagem , Hepatopatias Parasitárias/tratamento farmacológico , Masculino , Praziquantel/administração & dosagem , Praziquantel/uso terapêutico , Refugiados , Schistosoma mansoni/isolamento & purificação , Esquistossomose mansoni/complicações , Esquistossomose mansoni/diagnóstico por imagem , Esquistossomose mansoni/tratamento farmacológico , Esquistossomicidas/administração & dosagem , Esquistossomicidas/uso terapêutico , Esplenopatias/complicações , Esplenopatias/diagnóstico por imagem , Esplenopatias/tratamento farmacológico
11.
PLoS Negl Trop Dis ; 11(4): e0005417, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28369056

RESUMO

BACKGROUND: Schistosomiasis is endemic to several parts of the world. Among the species that affect humans, Schistosoma mansoni is one of the most common causes of illness. In regions where schistosomiasis mansoni is endemic, reinfection is responsible for the emergence of hepatosplenic schistosomiasis (HSS) with portal hypertension in about 10% of infected individuals. Regardless of its etiology, portal hypertension may bring about the formation of arteriovenous fistulas and pulmonary vascular dilation, thus constituting a pulmonary shunt and its presence has been associated with the occurrence of neurological complications. The objective of this study was to identify pulmonary shunt using TTCE in patients with HSS and esophageal varices, and to compare the abdominal ultrasound and endoscopy findings among patients with and without pulmonary shunt. METHODOLOGY/PRINCIPAL FINDINGS: In this case series, a total of 461 patients with schistosomiasis mansoni were prospectively evaluated using abdominal ultrasound and endoscopy and 71 presented with HSS with esophageal varices. Fifty seven patients remained in the final analysis. The mean age of the patients was 55 ± 14 years, and 65% were female. Pulmonary shunts were observed in 19 (33.3%) patients. On comparing the groups with and without pulmonary shunt, no significant differences were observed in relation to the abdominal ultrasound and endoscopic findings. When comparing the two subgroups with pulmonary shunts (grade 1 vs grades 2 and 3), it was observed that the subgroup with shunt grades 2 and 3 presented with a significantly higher frequency of an enlarged splenic vein diameter (>0.9 cm), and an advanced pattern of periportal hepatic fibrosis (P = 0.041 and P = 0.005, respectively). None of the patients with pulmonary shunts had severe neurological complications. CONCLUSIONS/SIGNIFICANCE: Our findings suggest that in HSS with esophageal varices the pulmonary shunts may be present in higher grades and that in this condition it was associated with ultrasound findings compatible with advanced HSS.


Assuntos
Varizes Esofágicas e Gástricas/diagnóstico por imagem , Hipertensão Portal/diagnóstico por imagem , Hepatopatias Parasitárias/diagnóstico por imagem , Schistosoma mansoni/isolamento & purificação , Esquistossomose mansoni/diagnóstico por imagem , Esplenopatias/diagnóstico por imagem , Abdome/diagnóstico por imagem , Adulto , Idoso , Animais , Ecocardiografia/métodos , Varizes Esofágicas e Gástricas/complicações , Varizes Esofágicas e Gástricas/parasitologia , Varizes Esofágicas e Gástricas/fisiopatologia , Feminino , Humanos , Hipertensão Portal/complicações , Hipertensão Portal/parasitologia , Hipertensão Portal/fisiopatologia , Hepatopatias Parasitárias/complicações , Hepatopatias Parasitárias/parasitologia , Hepatopatias Parasitárias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Esquistossomose mansoni/complicações , Esquistossomose mansoni/fisiopatologia , Esplenopatias/complicações , Esplenopatias/parasitologia , Esplenopatias/fisiopatologia , Ultrassonografia
13.
Rev Soc Bras Med Trop ; 50(6): 805-811, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29340458

RESUMO

INTRODUCTION: Despite the advances of disease control programs, severe forms of schistosomiasis are prevalent. The prevalence of the disease in areas frequented by tourists urges for permanent prevention and control. The aim of this study was to describe the morbidity of schistosomiasis in the district of Antônio Pereira, Ouro Preto, Minas Gerais, Brazil. METHODS: The proportion of positives was defined by Kato-Katz coproscopy and urinary POC-CCA rapid test. Hepatosplenic form was diagnosed using abdominal ultrasound. RESULTS: Out of 180 participants,97 were examined by Kato-Katz, with 4 (4.1%) being positive. Thirty-four (22.1%) out of 154 were positive by POC-CCA. Five (2.8%) of 177 examined by ultrasound had hepatosplenic form. One of them had undergone splenectomy. One (0.6%)participant had myeloradiculopathy. CONCLUSIONS: Severe forms of schistosomiasis are still prevalent in low endemic areas and should be thoroughly investigated.


Assuntos
Hepatopatias Parasitárias/epidemiologia , Schistosoma mansoni/isolamento & purificação , Esquistossomose mansoni/epidemiologia , Esplenopatias/epidemiologia , Animais , Antígenos de Helmintos/urina , Estudos Transversais , Escolaridade , Fezes/parasitologia , Feminino , Humanos , Hepatopatias Parasitárias/diagnóstico por imagem , Hepatopatias Parasitárias/parasitologia , Masculino , Morbidade , Prevalência , Esquistossomose mansoni/diagnóstico , Esplenopatias/diagnóstico por imagem , Esplenopatias/parasitologia
15.
Dig Dis Sci ; 61(7): 2118-26, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-26921079

RESUMO

BACKGROUND: Portal vein obstructive lesions associated with hypertrophy of the hepatic artery territory are observed in Schistosoma mansoni schistosomiasis. Liver perfusion scintigraphy is a method used for evaluation of hepatic perfusion changes in liver diseases. It has been suggested that, like in cirrhosis, where compensatory increase in perfusion through the hepatic artery is documented, perfusion changes occur in hepatosplenic schistosomiasis (HSS). AIMS: This study aims to determine changes in liver hemodynamics using hepatic perfusion scintigraphy and correlate them with clinical and laboratory variables and ultrasound findings in HSS. METHODS: Nineteen patients with schistosomiasis underwent ultrasound evaluation of degree of liver fibrosis, splenic length, and splenic and portal vein diameter, digestive endoscopy, and quantification of platelets. Subsequently, perfusion scintigraphy with measurement of hepatic perfusion index (HPI) was performed. RESULTS: It was observed that patients with hepatosplenic schistosomiasis had significantly higher HPI compared with normal individuals (p = 0.0029) and that this increase correlated with splenic length (p = 0.038) and diameter of esophageal varices (p = 0.0060). Angioscintigraphy showed high accuracy for predicting presence of large esophageal varices. CONCLUSIONS: Angioscintigraphy could show that patients with HSS had increased HPI, featuring greater liver "arterialization," as previously described for cirrhotic patients. Correlations were also observed between HPI and longitudinal splenic length, caliber of esophageal varices, caliber of portal vein, and blood platelet count. Angioscintigraphy is a promising technique for evaluation of hepatosplenic schistosomiasis.


Assuntos
Velocidade do Fluxo Sanguíneo/fisiologia , Hipertensão Portal/complicações , Hepatopatias Parasitárias/complicações , Fígado/irrigação sanguínea , Esquistossomose mansoni/patologia , Esplenopatias/complicações , Adulto , Idoso , Estudos Transversais , Técnicas de Diagnóstico por Radioisótopos , Feminino , Humanos , Hipertensão Portal/diagnóstico por imagem , Hipertensão Portal/fisiopatologia , Hepatopatias Parasitárias/diagnóstico por imagem , Hepatopatias Parasitárias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Esquistossomose mansoni/complicações , Esplenopatias/diagnóstico por imagem , Esplenopatias/fisiopatologia , Ultrassonografia
17.
Acta Trop ; 141(Pt B): 303-9, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25275346

RESUMO

Evidence of severe hepatobiliary morbidity associated with Opisthorchis viverrini liver fluke infection including cholangiocarcinoma (CCA) is scarce in Laos although O. viverrini infection is highly prevalent. We assessed hepatobiliary morbidity using abdominal ultrasonography (US) in O. viverrini adult patients in Saravan province, Southern Laos. A random sample of 431 O. viverrini patients from 10 villages underwent abdominal US. Mild, moderate and markedly advanced periductal fibrosis was diagnosed in 7.0%, 66.5%, and 17.0% of patients, respectively. Normal liver parenchyma was seen in only 9.5% of patients. Presence of gall stones (13.2%), sludge (1.4%), gall wall thickening (1.2%), bile duct dilatation (1.6%), fatty liver (12.0%), kidney stones (8.6%) and cysts (7.9%) were diagnosed in considerable frequencies. In five patients (1.2%) hepatobiliary lesions suggesting CCA were diagnosed. Tumour markers, i.e. Interleukin-6, plasminogen activator inhibitor and carbohydrate antigen 19-9 were within normal range. The number of CCA suspected liver masses and hepatobiliary morbidity diagnosed among clinically asymptomatic adult patients in O. viverrini endemic area presents a major public health concern in Laos. However, definitive diagnosis of Opisthorchis-related severe sequelae including CCA is urgently needed to gauge the burden of this deadly disease in Laos.


Assuntos
Neoplasias dos Ductos Biliares/epidemiologia , Ductos Biliares Intra-Hepáticos/patologia , Biomarcadores Tumorais/sangue , Colangiocarcinoma/epidemiologia , Opistorquíase/epidemiologia , Adulto , Animais , Neoplasias dos Ductos Biliares/sangue , Neoplasias dos Ductos Biliares/diagnóstico por imagem , Ductos Biliares Intra-Hepáticos/diagnóstico por imagem , Antígeno CA-19-9/sangue , Colangiocarcinoma/sangue , Colangiocarcinoma/diagnóstico por imagem , Estudos Transversais , Fígado Gorduroso/diagnóstico por imagem , Fígado Gorduroso/epidemiologia , Feminino , Humanos , Interleucina-6/sangue , Laos/epidemiologia , Hepatopatias Parasitárias/diagnóstico por imagem , Hepatopatias Parasitárias/epidemiologia , Masculino , Pessoa de Meia-Idade , Opistorquíase/diagnóstico por imagem , Opisthorchis , Inativadores de Plasminogênio/sangue , Prevalência , Índice de Gravidade de Doença , Ultrassonografia , Adulto Jovem
18.
Diagn Cytopathol ; 43(5): 392-4, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25350873

RESUMO

Charcot Leyden crystals are colorless, hexagonal, bipyramidal crystals formed from aggregation of material from disintegrating eosinophils. Eosinophilic infiltrate along with the presence of Charcot Leyden crystals is an indirect evidence of parasitic infestation. Here, we report a case where fine-needle aspiration cytology smears prepared from hepatic space occupying lesion showed numerous Charcot Leyden crystals along with eosinophilic infiltrate, indicating parasitic infection.


Assuntos
Eosinófilos/patologia , Glicoproteínas/química , Hepatopatias Parasitárias/diagnóstico , Fígado/parasitologia , Lisofosfolipase/química , Albendazol/uso terapêutico , Antiprotozoários/uso terapêutico , Biópsia por Agulha Fina , Movimento Celular , Cristalização , Eosinófilos/química , Eosinófilos/parasitologia , Histocitoquímica , Humanos , Fígado/diagnóstico por imagem , Fígado/patologia , Hepatopatias Parasitárias/diagnóstico por imagem , Hepatopatias Parasitárias/tratamento farmacológico , Hepatopatias Parasitárias/patologia , Masculino , Pessoa de Meia-Idade , Ultrassonografia
19.
Int J Clin Exp Pathol ; 7(9): 6339-44, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25337288

RESUMO

PURPOSE: We report the case of a 59-year-old male patient who presented with space-occupying lesions in the pancreas and liver suggestive of metastatic pancreatic cancer. MATERIALS AND METHODS: Whole-body F-18 fluorodeoxyglucose (FDG) PET/CT imaging and enhanced CT imaging of the lesions were performed in addition to abdominal ultrasound, ERCP, and MRCP. Tumor markers, including CA199 and AFP, were also evaluated. RESULTS: PET/CT imaging showed a soft tissue mass with indistinct boundaries in the head of the pancreas with a maximum SUV of 4.39. A less dense shadow was also found in the left lobe of the liver with an indistinct boundary and a maximum SUV of 4.13. Enhanced CT revealed an enhancing mass in the head of the pancreas on arterial phase imaging as well as a mildly enhancing focus in the left lobe of the liver. The patient was diagnosed with a space-occupying lesion of the uncinate process of the pancreas suggestive of pancreatic cancer with metastasis to the liver. However, serum tumor markers were normal. Postoperative pathology was consistent with chronic pancreatitis and old hepatic schistosomiasis associated with granulomatous inflammation of the liver. CONCLUSION: This case of mass-forming pancreatitis and granulomatous inflammation in old hepatic schistosomiasis mimicked metastatic pancreatic cancer on PET/CT. Such false positive lesions have not been reported before, and further exploration and investigation are needed.


Assuntos
Erros de Diagnóstico , Fluordesoxiglucose F18 , Granuloma/diagnóstico , Hepatopatias Parasitárias/diagnóstico , Neoplasias Hepáticas/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Pancreatite Crônica/diagnóstico , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Esquistossomose/diagnóstico , Tomografia Computadorizada por Raios X , Biópsia , Reações Falso-Positivas , Granuloma/diagnóstico por imagem , Granuloma/parasitologia , Granuloma/cirurgia , Humanos , Hepatopatias Parasitárias/diagnóstico por imagem , Hepatopatias Parasitárias/parasitologia , Hepatopatias Parasitárias/cirurgia , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/patologia , Pancreatite Crônica/diagnóstico por imagem , Pancreatite Crônica/cirurgia , Valor Preditivo dos Testes , Esquistossomose/diagnóstico por imagem , Esquistossomose/parasitologia , Esquistossomose/cirurgia , Imagem Corporal Total
20.
Parasitol Res ; 113(11): 3915-25, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25260691

RESUMO

The aim of this study is to review the worldwide acceptance of the World Health Organization (WHO) ultrasound protocol for assessing hepatosplenic morbidity due to Schistosoma mansoni since its publication in 2000. A PubMed literature research using the keywords "schistosomiasis and ultrasound," "schistosomiasis and ultrasonography," and "S. mansoni and ultrasound" from 2001 to 2012 was performed. Case reports, reviews, reports on abnormalities due to parasites other than S. mansoni, organ involvement other than the human liver, and reports where ultrasound method was not described were excluded. Six studies were retrieved from other Brazilian sources. Sixty studies on 37,424 patients from 15 countries were analyzed. The WHO protocol was applied with increasing frequency from 43.75% in the years 2001 to 2004 to 84.61% in 2009 to 2012. Results obtained using the pictorial image pattern approach of the protocol are reported in 38/41 studies, whereas measurements of portal branch walls were applied in 19/41 and results reported in 2/41 studies only. The practical usefulness of the pictorial approach of the WHO protocol is confirmed by its wide acceptance. This approach alone proved satisfactory in terms of reproducibility, assessment of evolution of pathology, and comparability between different settings. The measurements of portal branches, also part of the protocol, may be omitted without losing relevant information since results obtained by these measurements are nonspecific. This would save resources by reducing the time required for each examination. It is also more feasible for examiners who are not specialized in medical imaging. As with all protocols, incipient liver fibrosis is difficult to distinguish from normal ultrasound findings of the liver. The ability of this protocol to predict complications in severe cases should be further evaluated in a higher number of patients.


Assuntos
Hepatopatias Parasitárias/diagnóstico por imagem , Esquistossomose mansoni/diagnóstico por imagem , Animais , Brasil , Humanos , Cirrose Hepática/diagnóstico por imagem , Cirrose Hepática/parasitologia , Hepatopatias Parasitárias/patologia , Morbidade , Reprodutibilidade dos Testes , Schistosoma mansoni , Esquistossomose mansoni/patologia , Ultrassonografia , Organização Mundial da Saúde
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