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José Roberto Lambertucci - One of the best experts on this subject based on the ideXlab platform.
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edta dependent pseudothrombocytopenia in patients with hepatosplenic Schistosomiasis Mansoni a clinical management alert
Transactions of The Royal Society of Tropical Medicine and Hygiene, 2021Co-Authors: Guilherme Vaz De Melo Trindade, Thiago A Pereira, Julia Fonseca De Morais Caporali, Debora Vaz De Melo Trindade, Silvana Junia Roriz, Patricia Donado Vaz De Melo, José Roberto LambertucciAbstract:BACKGROUND Hepatosplenic Schistosomiasis Mansoni (HS) is associated with thrombocytopenia. Accurate platelet counts are required for identification and management of HS patients. EDTA-dependent pseudothrombocytopenia (EDTA-PTCP) is an in vitro phenomenon of anticoagulant-activated platelet agglutination resulting in low platelet counts by automated methods. The prevalence of EDTA-PCTP in Schistosomiasis is unknown and only one case has been described. Our aims were to determine the prevalence of EDTA-PTCP in HS and evaluate alternative methods to overcome this analytical error. METHODS Blood samples from 56 HS patients and 56 healthy volunteers were collected, and platelet counts were obtained using standard microscopy and automated (electric impedance) methods. Automated platelet counts and the presence of platelet clumps in blood smears were evaluated in samples collected in EDTA or sodium citrate tubes 20 and 180 min after blood collection. RESULTS EDTA-PTCP was more frequent in HS patients than healthy volunteers (8.92% vs 0.00%, p<0.0285). Platelet clumps and PTCP were also observed in samples collected in sodium citrate tubes, refuting its use as an alternative method. CONCLUSIONS Automated platelet counts in blood samples from HS patients should be performed right after blood collection in EDTA tubes and verified by manual counts in blood smears.
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Morbidity of Schistosomiasis Mansoni in the state of
2016Co-Authors: Minas Gerais Brazil, Sílvio Roberto Sousa-pereira, Ra Costa Drummond, Luciana Cristina, Santos Silva, Ronaldo Santos Do Amaral, Carlos Maurício Antunes, José Roberto LambertucciAbstract:myeloradiculopathy has been implemented in the state of Minas Gerais by the local Health Department. The state was divided in 28 regional health centers and the local representatives have been trained to identify and direct patients with hepatosplenic Schistosomiasis and neuroSchistosomiasis to a reference center in Belo Horizonte, the capital of the state of Minas Gerais. Seventy five patients with hepatosplenic Schistosomiasis and 54 with schistoso-mal myeloradiculopathy have been referred and examined in the reference center in a period of time of 3 years. Schistosomal myeloradiculopathy should be emphasized because the number of cases reported is increasing rapidly and when timely diagnosed and treated, they respond promptly to treatment. Left untreated, they die or become invalid for life. In our view, the time has come for more active investigation of the different aspects of morbidity caused by Schistosomiasis Mansoni in Brazil. Key words: Schistosomiasis- hepatosplenic Schistosomiasis- neuroSchistosomiasis- magnetic resonance imaging-myeloradiculopathy It has been estimated that 4 to 6 million people are infected by Schistosoma Mansoni in Brazil and that the states of Minas Gerais and Bahia concentrate 70 % of the cases. Based on two national surveys of schistosomiasi
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Received in 19/03/2011 Accepted in 11/05/2011 Pseudothrombocytopenia in Schistosomiasis Mansoni
2016Co-Authors: Faculdade De Medicina, José Roberto Lambertucci, Helena Duani, Pedro Henrique Prata, Minas Gerais, Belo Horizonte, Izabela VoietaAbstract:We wish to communicate the case of a young patient with Schistosomiasis Mansoni and pseudothrombocytopenia. Pseudothrombocytopenia (PTCP) reflects an in vitro phenomenon of anticoagulant-activated platelet agglutination that results in spuriously low platelet counts by electronic counting machines. In most cases, the phenomenon is ethylenediaminetetraacetic acid — a calcium chelator — (EDTA)-dependent1. With other anticoagulants, such as heparin and sodium citrate, this phenomenon is still possible, but rare. Pseudothrombocytopenia is induced by agglutinating antibodies that cause in vitro platelet clumping by binding glycoprotein IIb/IIIa receptors on platelets. This phenomenon is most frequently observed in association with autoimmune, neoplastic, cardiovascular, and chronic liver diseases. EDTA-dependent PTCP is reported to occur in 0.2 % of asymptomatic individuals, but the incidence may be a
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glomerulonephritis in Schistosomiasis Mansoni a time to reappraise
Revista Da Sociedade Brasileira De Medicina Tropical, 2010Co-Authors: Valerio Ladeira Rodrigues, Izabela Voieta, Alba Otoni, Carlos Antunes, José Roberto LambertucciAbstract:INTRODUCTION: The current prevalence of glomerulonephritis in patients with hepatosplenic Schistosomiasis Mansoni in Brazil was evaluated. METHODS: Sixty three patients (mean age 45.5±11 years) attending the outpatient infectious disease clinic of a University Hospital in Belo Horizonte, Brazil, from 2007 to 2009, were consecutively examined and enrolled in the present investigation. Diagnosis of hepatosplenic Schistosomiasis was based on epidemiological, clinical and parasitological data and imaging techniques. Eight patients, who presented >30mg/day albuminuria, were submitted to percutaneous ultrasound guided renal biopsy. Kidney tissue fragments were examined under light, direct immunofluorescence and electron microscopy. RESULTS: All patients showed mesangial enlargement. In five, mesangial hypercellularity was observed and four presented duplication of the glomerular basement membrane. Areas of glomerular sclerosis were diagnosed in four. Deposits of immunoglobulin M and C3 were present in six samples; deposits of IgG in four, IgA in three and C1q in two samples. In all patients, immunoglobulin A was reported in the lumen of renal tubules. Deposits of kappa and lambda were observed in six samples. Electron microscopy revealed dense deposits in the glomerular tissue of three patients. Arterial hypertension, small esophageal varices, slight increases in serum creatinine and decreases in serum albumin were associated with glomerular disease. CONCLUSIONS: Renal disease associated with hepatosplenic Schistosomiasis was verified in 12.7% of patients and type I membranoproliferative glomerulonephritis was observed in 50% of them. Schistosomal glomerulopathy still is an important problem in patients with hepatosplenic Schistosomiasis in Brazil.
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ultrasound in Schistosomiasis Mansoni
Memorias Do Instituto Oswaldo Cruz, 2010Co-Authors: Rogerio Augusto Pintosilva, Luciana Cristina Dos Santos Silva, Leonardo Campos De Queiroz, Leticia Martins Azeredo, José Roberto LambertucciAbstract:We reviewed ultrasound features in patients with Schistosomiasis Mansoni. The alterations that we observed in acute and hepatosplenic Schistosomiasis are described. The advantages and disadvantages of using ultrasound patterns in the evaluation of liver fibrosis are discussed. Other diseases that are important in the differential diagnosis of schistosomal liver fibrosis are presented. Ultrasound is an effective and flexible diagnostic tool in the evaluation of a variety of diseases. It presents no harmful effects to patients, allowing non-invasive studies in hospitalized patients and in other facilities.
Ana Lucia Coutinho Domingues - One of the best experts on this subject based on the ideXlab platform.
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the cost of a disease targeted for elimination in brazil the case of Schistosomiasis Mansoni
Memorias Do Instituto Oswaldo Cruz, 2019Co-Authors: Gilmara Lima Nascimento, Ana Lucia Coutinho Domingues, Helio Milani Pegado, Ricardo Arraes De Alencar Ximenes, Alexander Itria, Luciane Nascimento Cruz, Maria Regina Fernandes De OliveiraAbstract:Background Schistosomiasis Mansoni is a poverty-related parasitic infection that has a variety of clinical manifestations. We consider the disability and deaths caused by Schistosomiasis unacceptable for a tool-ready disease. Its condition in Brazil warrants an analysis that will enable better understanding of the local health losses and contribute to the complex decision-making process. Objective This study estimates the cost of Schistosomiasis in Brazil in 2015. Methods We conducted a cost of illness study of Schistosomiasis Mansoni in Brazil in 2015 based on a prevalence approach and from a societal perspective. The study included 26,499 Schistosomiasis carriers, 397 hepatosplenic cases, 48 cases with the neurological form, 284 hospitalisations, and 11,368.26 years of life lost (YLL) of which 5,187 years are attributable to economically active age groups. Results The total cost of Schistosomiasis Mansoni in Brazil was estimated to be US$ 41,7million in 2015 with 94.61% of this being indirect costs. Conclusions The economic burden of Schistosomiasis Mansoni in Brazil is high and results in the loss of productivity. Its persistence in Brazil is a challenge to public health and requires inter-sectorial interventions in areas such as indoor water supply, basic sanitation, and education.
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liver ultrasound elastography for the evaluation of periportal fibrosis in Schistosomiasis Mansoni a cross sectional study
bioRxiv, 2018Co-Authors: Joelma Carvalho Santos, Silvia Maria Lucena Montenegro, Edmundo Pessoa De Almeida Lopes, Andrea Doria Batista, Carla Maria Mola Vasconcelos, Roberto Souza Lemos, Valter Romao De Souza, Alain Dessein, Helia Dessein, Ana Lucia Coutinho DominguesAbstract:Background: ARFI elastrography has been used as a noninvasive method to assess the severity of liver fibrosis in viral hepatitis, although with few studies in Schistosomiasis Mansoni. We aimed to evaluate the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point. Methodology/Principal findings: This cross-sectional study included 358 adult schistosomotic patients subjected to US and pSWE on the right lobe. Two hundred two patients (62.0%) were women, with a median age of 54 (ranging 18 to 92) years. The pSWE measurements were compared to the US patterns of PPF, as gold standard, according to the Niamey classification. The performance of pSWE was calculated as the area under the ROC curve (AUC). Patients were further classified into two groups: 86 patients with mild PPF and 272 patients with significant PPF. The median pSWE of the significant fibrosis group was higher (1.40 m/s) than that of mild fibrosis group (1.14 m/s, p 1.39 m/s, with specificity of 86.1% and positive predictive value of 92.0%. Conclusions/Significance: pSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF.
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Pulmonary shunts in severe hepatosplenic Schistosomiasis: Diagnosis by contrast echocardiography and their relationship with abdominal ultrasound findings.
Public Library of Science (PLoS), 2017Co-Authors: Liana Gonçalves-macedo, Ana Lucia Coutinho Domingues, Edmundo Pessoa Lopes, Carlos Feitosa Luna, Vitor Gomes Mota, Mônica Moraes De Chaves Becker, Brivaldo Markman-filhoAbstract: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.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.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
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new index for the diagnosis of liver fibrosis in Schistosomiasis Mansoni
Arquivos De Gastroenterologia, 2017Co-Authors: Ana Virginia Matos Sa Barreto, Silvia Maria Lucena Montenegro, Edmundo Pessoa De Almeida Lopes, Ana Lucia Coutinho Domingues, Vinicius Martins Alecrim, Tiberio Batista De Medeiros, Joao Roberto Maciel Martins, Helena B Nader, George Tadeu Nunes Diniz, Clarice N L MoraisAbstract:- Periportal fibrosis is the major pathological consequence of the Schistosoma Mansoni infection.
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splenectomy improves hemostatic and liver functions in hepatosplenic Schistosomiasis Mansoni
PLOS ONE, 2015Co-Authors: Luiz Arthur Calheiros Leite, Adenor Almeida Pimenta Filho, Rita De Cassia Dos Santos Ferreira, Caique Silveira Martins Da Fonseca, Bianka Santana Dos Santos, Silvia Maria Lucena Montenegro, Edmundo Pessoa De Almeida Lopes, Ana Lucia Coutinho Domingues, James S Owen, Vera Lucia De Menezes LimaAbstract:Background Schistosomiasis Mansoni is a chronic liver disease, in which some patients (5–10%) progress to the most severe form, hepatosplenic Schistosomiasis. This form is associated with portal hypertension and splenomegaly, and often episodes of gastrointestinal bleeding, even with liver function preserved. Splenectomy is a validated procedure to reduce portal hypertension following digestive bleeding. Here, we evaluate beneficial effects of splenectomy on blood coagulation factors and liver function tests in hepatosplenic Schistosomiasis Mansoni compared to non-operated patients.
Vera Lucia De Menezes Lima - One of the best experts on this subject based on the ideXlab platform.
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splenectomy improves hemostatic and liver functions in hepatosplenic Schistosomiasis Mansoni
PLOS ONE, 2015Co-Authors: Luiz Arthur Calheiros Leite, Adenor Almeida Pimenta Filho, Rita De Cassia Dos Santos Ferreira, Caique Silveira Martins Da Fonseca, Bianka Santana Dos Santos, Silvia Maria Lucena Montenegro, Edmundo Pessoa De Almeida Lopes, Ana Lucia Coutinho Domingues, James S Owen, Vera Lucia De Menezes LimaAbstract:Background Schistosomiasis Mansoni is a chronic liver disease, in which some patients (5–10%) progress to the most severe form, hepatosplenic Schistosomiasis. This form is associated with portal hypertension and splenomegaly, and often episodes of gastrointestinal bleeding, even with liver function preserved. Splenectomy is a validated procedure to reduce portal hypertension following digestive bleeding. Here, we evaluate beneficial effects of splenectomy on blood coagulation factors and liver function tests in hepatosplenic Schistosomiasis Mansoni compared to non-operated patients.
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human plasma lipid modulation in Schistosomiasis Mansoni depends on apolipoprotein e polymorphism
PLOS ONE, 2014Co-Authors: Caique Silveira Martins Da Fonseca, Adenor Almeida Pimenta Filho, Bianka Santana Dos Santos, Ana Lucia Coutinho Domingues, James S Owen, Cesar Augusto Da Silva, Vera Lucia De Menezes LimaAbstract:Background: Schistosomiasis Mansoni is a parasitic liver disease, which causes several metabolic disturbances. Here, we evaluate the influence of Apolipoprotein E (APOE) gene polymorphism, a known modulator of lipid metabolism, on plasma lipid levels in patients with hepatosplenic Schistosomiasis. Methodology/principal findings: Blood samples were used for APOE genotyping and to measure total cholesterol (TC), LDL-C, HDL-C and triglycerides. Schistosomiasis patients had reduced TC, LDL-C and triglycerides (25%, 38% and 32% lower, respectively; P e3>e4) was absent in patients (e2 or e4>e3), and the increase in HDL-C of e2 or e4 patients compared to e3 patients was not seen in the control groups. Conclusion/significance: We confirm that human Schistosomiasis causes dyslipidemia and report for the first time that certain changes in plasma lipid and lipoprotein levels depend on APOE gene polymorphism. Importantly, we also concluded that S. Mansoni disrupts the expected regulation of plasma lipids by the different ApoE isoforms. This finding suggests ways to identify new metabolic pathways affected by Schistosomiasis and also potential molecular targets to treat associated morbidities.
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hemostatic dysfunction is increased in patients with hepatosplenic Schistosomiasis Mansoni and advanced periportal fibrosis
PLOS Neglected Tropical Diseases, 2013Co-Authors: Luiz Arthur Calheiros Leite, Adenor Almeida Pimenta Filho, Rita De Cassia Dos Santos Ferreira, Caique Silveira Martins Da Fonseca, Bianka Santana Dos Santos, Silvia Maria Lucena Montenegro, Edmundo Pessoa De Almeida Lopes, Ana Lucia Coutinho Domingues, James S Owen, Vera Lucia De Menezes LimaAbstract:Background Schistosomiasis Mansoni is an endemic parasitic disease and a public health problem in Northeast Brazil. In some patients, hepatic abnormalities lead to periportal fibrosis and result in the most severe clinical form, hepatosplenic Schistosomiasis. This study aimed to evaluate whether abnormal blood coagulation and liver function tests in patients with hepatosplenic Schistosomiasis (n = 55) correlate with the severity of their periportal fibrosis. Methodology/Principal Findings Blood samples were used for liver function tests, hemogram and prothrombin time (International Normalized Ratio, INR). The blood coagulation factors (II, VII, VIII, IX and X), protein C and antithrombin IIa (ATIIa), plasminogen activator inhibitor 1 (PAI-1) and D-dimer were measured by photometry or enzyme linked immunosorbent assay. Hyperfibrinolysis was defined on the basis of PAI-1 levels and a D-dimer concentration greater than a standard cut-off of 483 ng/mL. Standard liver function tests were all abnormal in the patient group compared to healthy controls (n = 29), including raised serum transaminases (p<0.001) and lower levels of albumin (p = 0.0156). Platelet counts were 50% lower in patients, while for coagulation factors there was a 40% increase in the INR (p<0.001) and reduced levels of Factor VII and protein C in patients compared to the controls (both p<0.001). Additionally, patients with more advanced fibrosis (n = 38) had lower levels of protein C compared to those with only central fibrosis (p = 0.0124). The concentration of plasma PAI-1 in patients was one-third that of the control group (p<0.001), and D-dimer levels 2.2 times higher (p<0.001) with 13 of the 55 patients having levels above the cut-off. Conclusion/Significance This study confirms that hemostatic abnormalities are associated with reduced liver function and increased liver fibrosis. Of note was the finding that a quarter of patients with hepatosplenic Schistosomiasis and advanced periportal fibrosis have hyperfibrinolysis, as judged by excessive levels of D-dimer, which may predispose them to gastrointestinal bleeding.
Silvia Maria Lucena Montenegro - One of the best experts on this subject based on the ideXlab platform.
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liver ultrasound elastography for the evaluation of periportal fibrosis in Schistosomiasis Mansoni a cross sectional study
bioRxiv, 2018Co-Authors: Joelma Carvalho Santos, Silvia Maria Lucena Montenegro, Edmundo Pessoa De Almeida Lopes, Andrea Doria Batista, Carla Maria Mola Vasconcelos, Roberto Souza Lemos, Valter Romao De Souza, Alain Dessein, Helia Dessein, Ana Lucia Coutinho DominguesAbstract:Background: ARFI elastrography has been used as a noninvasive method to assess the severity of liver fibrosis in viral hepatitis, although with few studies in Schistosomiasis Mansoni. We aimed to evaluate the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point. Methodology/Principal findings: This cross-sectional study included 358 adult schistosomotic patients subjected to US and pSWE on the right lobe. Two hundred two patients (62.0%) were women, with a median age of 54 (ranging 18 to 92) years. The pSWE measurements were compared to the US patterns of PPF, as gold standard, according to the Niamey classification. The performance of pSWE was calculated as the area under the ROC curve (AUC). Patients were further classified into two groups: 86 patients with mild PPF and 272 patients with significant PPF. The median pSWE of the significant fibrosis group was higher (1.40 m/s) than that of mild fibrosis group (1.14 m/s, p 1.39 m/s, with specificity of 86.1% and positive predictive value of 92.0%. Conclusions/Significance: pSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF.
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new index for the diagnosis of liver fibrosis in Schistosomiasis Mansoni
Arquivos De Gastroenterologia, 2017Co-Authors: Ana Virginia Matos Sa Barreto, Silvia Maria Lucena Montenegro, Edmundo Pessoa De Almeida Lopes, Ana Lucia Coutinho Domingues, Vinicius Martins Alecrim, Tiberio Batista De Medeiros, Joao Roberto Maciel Martins, Helena B Nader, George Tadeu Nunes Diniz, Clarice N L MoraisAbstract:- Periportal fibrosis is the major pathological consequence of the Schistosoma Mansoni infection.
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splenectomy improves hemostatic and liver functions in hepatosplenic Schistosomiasis Mansoni
PLOS ONE, 2015Co-Authors: Luiz Arthur Calheiros Leite, Adenor Almeida Pimenta Filho, Rita De Cassia Dos Santos Ferreira, Caique Silveira Martins Da Fonseca, Bianka Santana Dos Santos, Silvia Maria Lucena Montenegro, Edmundo Pessoa De Almeida Lopes, Ana Lucia Coutinho Domingues, James S Owen, Vera Lucia De Menezes LimaAbstract:Background Schistosomiasis Mansoni is a chronic liver disease, in which some patients (5–10%) progress to the most severe form, hepatosplenic Schistosomiasis. This form is associated with portal hypertension and splenomegaly, and often episodes of gastrointestinal bleeding, even with liver function preserved. Splenectomy is a validated procedure to reduce portal hypertension following digestive bleeding. Here, we evaluate beneficial effects of splenectomy on blood coagulation factors and liver function tests in hepatosplenic Schistosomiasis Mansoni compared to non-operated patients.
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hemostatic dysfunction is increased in patients with hepatosplenic Schistosomiasis Mansoni and advanced periportal fibrosis
PLOS Neglected Tropical Diseases, 2013Co-Authors: Luiz Arthur Calheiros Leite, Adenor Almeida Pimenta Filho, Rita De Cassia Dos Santos Ferreira, Caique Silveira Martins Da Fonseca, Bianka Santana Dos Santos, Silvia Maria Lucena Montenegro, Edmundo Pessoa De Almeida Lopes, Ana Lucia Coutinho Domingues, James S Owen, Vera Lucia De Menezes LimaAbstract:Background Schistosomiasis Mansoni is an endemic parasitic disease and a public health problem in Northeast Brazil. In some patients, hepatic abnormalities lead to periportal fibrosis and result in the most severe clinical form, hepatosplenic Schistosomiasis. This study aimed to evaluate whether abnormal blood coagulation and liver function tests in patients with hepatosplenic Schistosomiasis (n = 55) correlate with the severity of their periportal fibrosis. Methodology/Principal Findings Blood samples were used for liver function tests, hemogram and prothrombin time (International Normalized Ratio, INR). The blood coagulation factors (II, VII, VIII, IX and X), protein C and antithrombin IIa (ATIIa), plasminogen activator inhibitor 1 (PAI-1) and D-dimer were measured by photometry or enzyme linked immunosorbent assay. Hyperfibrinolysis was defined on the basis of PAI-1 levels and a D-dimer concentration greater than a standard cut-off of 483 ng/mL. Standard liver function tests were all abnormal in the patient group compared to healthy controls (n = 29), including raised serum transaminases (p<0.001) and lower levels of albumin (p = 0.0156). Platelet counts were 50% lower in patients, while for coagulation factors there was a 40% increase in the INR (p<0.001) and reduced levels of Factor VII and protein C in patients compared to the controls (both p<0.001). Additionally, patients with more advanced fibrosis (n = 38) had lower levels of protein C compared to those with only central fibrosis (p = 0.0124). The concentration of plasma PAI-1 in patients was one-third that of the control group (p<0.001), and D-dimer levels 2.2 times higher (p<0.001) with 13 of the 55 patients having levels above the cut-off. Conclusion/Significance This study confirms that hemostatic abnormalities are associated with reduced liver function and increased liver fibrosis. Of note was the finding that a quarter of patients with hepatosplenic Schistosomiasis and advanced periportal fibrosis have hyperfibrinolysis, as judged by excessive levels of D-dimer, which may predispose them to gastrointestinal bleeding.
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association between Schistosomiasis Mansoni and hepatitis c systematic review
Revista De Saude Publica, 2013Co-Authors: Daniele Silva De Moraes Vanlume, Edmundo Pessoa De Almeida Lopes, Ana Lucia Coutinho Domingues, Maria De Fatima Pessoa Militao De Albuquerque, Alexandre Ignacio De Souza, Clarice N L Morais, Silvia Maria Lucena MontenegroAbstract:OBJECTIVE: To perform a systematic review of the prevalence of the HCV/ S. Mansoni co-infection and associated factors in Schistosoma Mansoni -infected populations. METHODS: The bibliographic search was carried out using the Medline, Lilacs, SciELO, Cochrane Library and Ibecs databases. The criteria for the studies' selection and the extraction data were based on systematic review methods. Forty five studies were found, with nine being excluded in a first screening. Thirteen articles were used for data extraction. RESULTS: The HCV infection rates in Schistosomiasis populations range from 1% in Ethiopia to 50% in Egypt. Several studies had poorly defined methodologies, even in areas characterized by an association between hepatitis C and Schistosomiasis, such as Brazil and Egypt, which meant conclusions were inconsistent. HCV infection rates in schistosomotic populations were heterogeneous and risk factors for acquiring the virus varied widely. CONCLUSIONS: Despite the limitations, this review may help to identify regions with higher rates of hepatitis C and Schistosomiasis association. However, more studies are necessary for the development of public health policies on prevention and control of both diseases.
Bianka Santana Dos Santos - One of the best experts on this subject based on the ideXlab platform.
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RESEARCH ARTICLE Splenectomy Improves Hemostatic and Liver Functions in Hepatosplenic Schistosomiasis
2016Co-Authors: Luiz Arthur, Bianka Santana Dos Santos, Calheiros Leite, Adenor Almeida, Pimenta Filho, Rita De Cássia Dos, Santos Ferreira, Caíque Silveira, Martins Fonseca, Maria Lucena MontenegroAbstract:Background Schistosomiasis Mansoni is a chronic liver disease, in which some patients (5–10%) prog-ress to the most severe form, hepatosplenic Schistosomiasis. This form is associated with portal hypertension and splenomegaly, and often episodes of gastrointestinal bleeding, even with liver function preserved. Splenectomy is a validated procedure to reduce portal hypertension following digestive bleeding. Here, we evaluate beneficial effects of splenec-tomy on blood coagulation factors and liver function tests in hepatosplenic Schistosomiasis Mansoni compared to non-operated patients. Methodology/Principal Findings Forty-five patients who had undergone splenectomy surgery were assessed by laboratory analyses and ultrasound examination and compared to a non-operated group (n = 55). Blood samples were obtained for liver function tests, platelet count and prothrombin time. Coagulation factors (II, VII, VIII, IX and X), protein C and antithrombin IIa, plasminogen activator inhibitor-1 were measured by routine photometric, chromogenic or enzyme-linke
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splenectomy improves hemostatic and liver functions in hepatosplenic Schistosomiasis Mansoni
PLOS ONE, 2015Co-Authors: Luiz Arthur Calheiros Leite, Adenor Almeida Pimenta Filho, Rita De Cassia Dos Santos Ferreira, Caique Silveira Martins Da Fonseca, Bianka Santana Dos Santos, Silvia Maria Lucena Montenegro, Edmundo Pessoa De Almeida Lopes, Ana Lucia Coutinho Domingues, James S Owen, Vera Lucia De Menezes LimaAbstract:Background Schistosomiasis Mansoni is a chronic liver disease, in which some patients (5–10%) progress to the most severe form, hepatosplenic Schistosomiasis. This form is associated with portal hypertension and splenomegaly, and often episodes of gastrointestinal bleeding, even with liver function preserved. Splenectomy is a validated procedure to reduce portal hypertension following digestive bleeding. Here, we evaluate beneficial effects of splenectomy on blood coagulation factors and liver function tests in hepatosplenic Schistosomiasis Mansoni compared to non-operated patients.
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human plasma lipid modulation in Schistosomiasis Mansoni depends on apolipoprotein e polymorphism
PLOS ONE, 2014Co-Authors: Caique Silveira Martins Da Fonseca, Adenor Almeida Pimenta Filho, Bianka Santana Dos Santos, Ana Lucia Coutinho Domingues, James S Owen, Cesar Augusto Da Silva, Vera Lucia De Menezes LimaAbstract:Background: Schistosomiasis Mansoni is a parasitic liver disease, which causes several metabolic disturbances. Here, we evaluate the influence of Apolipoprotein E (APOE) gene polymorphism, a known modulator of lipid metabolism, on plasma lipid levels in patients with hepatosplenic Schistosomiasis. Methodology/principal findings: Blood samples were used for APOE genotyping and to measure total cholesterol (TC), LDL-C, HDL-C and triglycerides. Schistosomiasis patients had reduced TC, LDL-C and triglycerides (25%, 38% and 32% lower, respectively; P e3>e4) was absent in patients (e2 or e4>e3), and the increase in HDL-C of e2 or e4 patients compared to e3 patients was not seen in the control groups. Conclusion/significance: We confirm that human Schistosomiasis causes dyslipidemia and report for the first time that certain changes in plasma lipid and lipoprotein levels depend on APOE gene polymorphism. Importantly, we also concluded that S. Mansoni disrupts the expected regulation of plasma lipids by the different ApoE isoforms. This finding suggests ways to identify new metabolic pathways affected by Schistosomiasis and also potential molecular targets to treat associated morbidities.
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hemostatic dysfunction is increased in patients with hepatosplenic Schistosomiasis Mansoni and advanced periportal fibrosis
PLOS Neglected Tropical Diseases, 2013Co-Authors: Luiz Arthur Calheiros Leite, Adenor Almeida Pimenta Filho, Rita De Cassia Dos Santos Ferreira, Caique Silveira Martins Da Fonseca, Bianka Santana Dos Santos, Silvia Maria Lucena Montenegro, Edmundo Pessoa De Almeida Lopes, Ana Lucia Coutinho Domingues, James S Owen, Vera Lucia De Menezes LimaAbstract:Background Schistosomiasis Mansoni is an endemic parasitic disease and a public health problem in Northeast Brazil. In some patients, hepatic abnormalities lead to periportal fibrosis and result in the most severe clinical form, hepatosplenic Schistosomiasis. This study aimed to evaluate whether abnormal blood coagulation and liver function tests in patients with hepatosplenic Schistosomiasis (n = 55) correlate with the severity of their periportal fibrosis. Methodology/Principal Findings Blood samples were used for liver function tests, hemogram and prothrombin time (International Normalized Ratio, INR). The blood coagulation factors (II, VII, VIII, IX and X), protein C and antithrombin IIa (ATIIa), plasminogen activator inhibitor 1 (PAI-1) and D-dimer were measured by photometry or enzyme linked immunosorbent assay. Hyperfibrinolysis was defined on the basis of PAI-1 levels and a D-dimer concentration greater than a standard cut-off of 483 ng/mL. Standard liver function tests were all abnormal in the patient group compared to healthy controls (n = 29), including raised serum transaminases (p<0.001) and lower levels of albumin (p = 0.0156). Platelet counts were 50% lower in patients, while for coagulation factors there was a 40% increase in the INR (p<0.001) and reduced levels of Factor VII and protein C in patients compared to the controls (both p<0.001). Additionally, patients with more advanced fibrosis (n = 38) had lower levels of protein C compared to those with only central fibrosis (p = 0.0124). The concentration of plasma PAI-1 in patients was one-third that of the control group (p<0.001), and D-dimer levels 2.2 times higher (p<0.001) with 13 of the 55 patients having levels above the cut-off. Conclusion/Significance This study confirms that hemostatic abnormalities are associated with reduced liver function and increased liver fibrosis. Of note was the finding that a quarter of patients with hepatosplenic Schistosomiasis and advanced periportal fibrosis have hyperfibrinolysis, as judged by excessive levels of D-dimer, which may predispose them to gastrointestinal bleeding.
