ABSTRACT
Evaluation of hepatic fibrosis is usually performed by histopathological examination of biopsies. However, this is an invasive and potentially dangerous procedure. Several studies have proposed serum biological markers of hepatic fibrosis. This communication evaluates the use of serum cytokines as markers of hepatic fibrosis in hepatitis C, schistosomiasis, and co-infection.
Subject(s)
Adult , Humans , Cytokines/blood , Hepatitis C/immunology , Liver Cirrhosis/parasitology , Schistosomiasis/immunology , Biomarkers/blood , Cytokines/immunology , Enzyme-Linked Immunosorbent Assay , Hepatitis C/complications , /blood , Liver Cirrhosis/immunology , Predictive Value of Tests , Reproducibility of Results , Schistosomiasis/complications , Transforming Growth Factor beta/blood , Tumor Necrosis Factor-alpha/bloodABSTRACT
Portal hypertension is a frequent complication of chronic liver disease, detected not only in schistosomiasis, but also in cirrhosis of any etiology. Vascular alterations in the colonic mucosa are a potential source for acute or chronic bleeding and have been observed in patients with portal hypertension. The purpose of this prospective study was to describe and propose a classification for the vascular alterations of portal hypertension in the colonic mucosa among patients with hepatosplenic schistosomiasis mansoni. One or more alterations of portal colopathy were observed in all patients and they were classified according to their intensity, obeying the classification proposed by the authors. Portal colopathy is an important finding in hepatosplenic schistosomiasis and might be the cause of lower gastrointestinal bleeding in patients with severe portal hypertension.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Colonic Diseases , Hypertension, Portal , Liver Diseases, Parasitic , Schistosomiasis mansoni , Splenic Diseases , Endoscopy, Gastrointestinal , Intestinal Mucosa , Prospective Studies , Severity of Illness IndexABSTRACT
Biopsias endoscópicas do antro e da borda da lesäo péptica (úlcera gástrica e úlcera duodenal)foram obtidas de 56 pacientes para estudo histológico e microbiológico, no sentido de se determinar a ocorrência do C. pylori. Trinta e nove pacientes apresentaram evidências de gastrite antral e em 37 (94,8%) deles o bacilo foi detectado, enquanto que nos 17 com histologia normal a cultura foi positiva em somente dois (p<0,01). Nos pacientes com úlcera duodenal e úlcera gástrica a positividade para o C. pylori, no fragmento da borda da lesäo, foi de 100% e 88,8%, respectivamente. Os achados sobre a microbiologia do C. pylori näo diferiram daqueles previamente descritos em estudos similares. A microscopia eletrónica o bacilo foi encontrado próximo ou aderido às superfícies celulares sem haver sinais e localizaçäo intraepitelial. Este estudo confirma a associaçäo do C. pylori com a gastrite e a úlcera gastroduodenal, descrita na literatura