Correlation beteeen platelet count and both livr fibrosis and spleen diameter in patients with schistosomiasis mansnni / Correlação entre o número de plaquetas e o grau de fibrose hepática e o tamanho do baço em pacientes com Esquistossomose mansoni

Context Studies have described the correlation between platelet count and the stages of fibrosis in chronic viral hepatitis, but few publications have studied this correlation in Schistosomiasis mansoni. Objectives Therefore, this study aimed to correlate platelet count with both the periportal fibrosis pattern and spleen diameter evaluated by ultrasound exam in patients with Schistosomiasis mansoni. Methods Patients with Schistosomiasis mansoni were evaluated by abdominal ultrasound by a single examiner for the determination of periportal fibrosis pattern (Niamey classification) and spleen diameter. Platelet counts were performed in an automated cell counter. Results One hundred eighty-seven patients with Schistosomiasis mansoni (mean age: 50.2 years) were included in the study, 114 of whom (61%) were women. Based on the Niamey classification, the ultrasound analysis revealed that 37, 64, 64 and 22 patients exhibited patterns C, D, E and F, respectively. In these four groups, the mean number of platelets was 264, 196, 127 and 103 x 109/L and mean spleen diameter was 9.2, 11.9, 14.9 and 16.2 centimeters, respectively. A reduction in platelet count was significantly associated with both the progression of the periportal fibrosis and the increase in spleen size. Conclusions Platelet count in patients with Schistosomiasis mansoni was inversely correlated with the severity of periportal fibrosis and spleen diameter. .

Contexto Estudos vem descrevendo correlação entre o número de plaquetas e o grau de fibrose hepática na hepatite viral crônica, mas poucas publicações estudaram esta correlação em pacientes com Esquistossomose mansoni. Objetivos Correlacionar a contagem de plaquetas com o padrão de fibrose periportal e com o diâmetro do baço, avaliados pela ultrassonografia em pacientes com Esquistossomose mansoni. Métodos Os pacientes com Esquistossomose mansoni foram avaliados pela ultrassonografia abdominal, por um único examinador, para determinação do padrão de fibrose periportal (classificação de Niamey) e do diâmetro do baço. A contagem de plaquetas foi realizada em contador automatizado. Resultados Cento e oitenta e sete pacientes com Esquistossomose mansoni com média de idade de 50,2 anos foram incluídos no estudo, 114 (61%) dos quais eram mulheres. De acordo com a classificação de Niamey, a ultrassonografia revelou que 37, 64, 64 e 22 pacientes exibiam padrões C, D, E e F, respectivamente. Nestes quatro grupos, o número médio de plaquetas foi 264, 196, 127 e 103 x 109/L, respectivamente, e o diâmetro médio do baço foi 9,2, 11,9, 14,9 e 16,2 centímetros, respectivamente. Observou-se, portanto, redução significativa na contagem de plaquetas associada à progressão da fibrose periportal e ao aumento do tamanho do baço. Conclusões Neste estudo verificou-se que a contagem de plaquetas foi inversamente correlacionada com o padrão de fibrose periportal, como também com o diâmetro do baço nos pacientes com Esquistossomose mansoni. .

HBV and HCV serological markers in patients with the hepatosplenic form of mansonic schistosomiasis / Marcadores sorológicos do VHB e VHC em pacientes com esquistossomose mansônica na forma hepatoesplênica

CONTEXT: Blood transfusion is one of the major risk factors for the transmission of the hepatitis B (HBV) and C (HCV) viruses. However, there are no reports describing the endoscopic transmission of these viruses in patients with the hepatosplenic form of schistosomiasis. OBJECTIVE: To estimate the prevalence of serological markers of HBV and HCV in patients with the hepatosplenic form of schistosomiasis and evaluate the possible risk factors associated with these infections. METHODS: A cross-sectional study was conducted on 230 patients with hepatosplenic form of schistosomiasis who attended a university hospital in Recife, Northeastern Brazil, from February to August 2008. The patients answered a standardized questionnaire about risk factors. Serum samples were analyzed for anti-HBc total, anti-HBs, HBsAg, and anti-HCV using enzyme-linked immunosorbent assays. Univariate analysis and multiple logistic regression were performed. RESULTS: The prevalence was 30 percent for anti-HBc total and/or HBsAg and 7.4 percent for anti-HCV. There was a higher frequency of the serological markers in females and in patients aged .50 years. A significant association was detected between the presence of anti-HCV and the receipt of six or more blood transfusions. There was no association of history and number of digestive endoscopies with the serological markers analyzed. CONCLUSIONS: We observed a higher prevalence of serological markers for HBV and a lower prevalence of anti-HCV. Our results indicate that females and patients of an advanced age are the most affected categories and that patients that received multiple transfusions are at a higher probability of HCV infection.

CONTEXTO: A transfusão sanguínea destaca-se entre os fatores de risco implicados na transmissão dos vírus das hepatites B (VHB) e C (VHC); entretanto não há relatos da transmissão endoscópica destes vírus em pacientes com esquistossomose na forma hepatoesplênica. OBJETIVO: Estimar a prevalência dos marcadores sorológicos do VHB e VHC em pacientes com esquistossomose hepatoesplênica e avaliar os possíveis fatores de risco associados a essas infecções. MÉTODOS: Estudo do tipo transversal, com 230 pacientes com esquistossomose hepatoesplênica atendidos em um Hospital Universitário de Recife, PE, Brasil, no período de fevereiro a agosto de 2008. Os pacientes responderam a um questionário padronizado sobre os fatores de risco. Nas amostras de soro foram pesquisados o anti-HBc total, o anti-HBs, o HBsAg e o anti-VHC por ensaio imunoenzimático. As análises estatísticas utilizadas foram a univariada e a regressão logística múltipla. RESULTADOS: Encontrou-se prevalencia de 30 por cento para anti-HBc total e/ou HBsAg e 7,4 por cento para o anti-VHC. Houve maior frequencia de pacientes positivos do sexo feminino e idade .50 anos para os marcadores analisados. Verificou-se associação significativa entre a presenca do anti-HCV e a categoria de seis ou mais transfusões. Nao foi constatada associação do antecedente e numero de endoscopias digestivas com os marcadores sorologicos analisados. CONCLUSÕES: Constatou-se maior prevalência de marcadores sorológicos do VHB e menor prevalência para o anti-VHC. Evidenciou-se o sexo feminino e paciente de idade avançada como as categorias mais atingidas e maior probabilidade da infecção pelo VHC em pacientes politransfundidos.

Avaliação das citocinas IL-10 e IL-13 como mediadores na progressão da fibrose de Symmers em portadores de esquistossomose mansônica na forma hepatoesplênica / Evaluation of the cytokines IL-10 and IL-13 as mediators in the progression of symmers fibrosis in patients with hepatosplenic schistosomiasis mansoni

OBJETIVO: Investigar os níveis de IL-10 e IL-13 no soro de portadores da esquistossomose mansônica na forma hepatoesplênica (EHE), avaliando o papel destas citocinas no desenvolvimento da fibrose hepática. MÉTODOS: O estudo foi prospectivo e analítico, desenvolvido no Departamento de Cirurgia da Universidade Federal de Pernambuco, Laboratório de Imunologia Keizo Asami. Foram estudados três grupos: Grupo I - 25 portadores de esquistossomose mansônica na forma hepatoesplênica e não submetidos a tratamento cirúrgico; Grupo II - 30 submetidos à esplenectomia e ligadura da veia gástrica esquerda; Grupo III - 33 indivíduos sem esquistossomose mansônica na forma hepatoesplênica ou qualquer outra doença ou agravo que comprometesse a reserva funcional hepática. As concentrações séricas de IL-10 e IL-13 foram obtidas pelo método ELISA. Considerando-se a natureza não paramétrica, todas as concentrações foram analisadas pelo teste de Kruskal-Wallis. p<0,05 foi usado para rejeição da hipótese de nulidade. RESULTADOS: As médias das concentrações de IL-10, em ng/mL, no soro foram: GI 50,0 ± 59,0; GII 38,0 ± 270; GIII 38,0 ± 20,0. As concentrações de IL-13, em ng/mL, no soro dos pacientes foram respectivamente: GI 41,0 ± 93,0; GII 16,0 ± 17,0; GIII 18,0 ± 34,0. Não se observou diferença significante entre as médias das concentrações de IL-10 e IL-13 entre os grupos de estudo (p>0,05). CONCLUSÃO: As médias das concentrações séricas de IL-10 e IL-13 foram similares nos três grupos estudados, indicando que, possivelmente, estas citocinas no soro não estejam associadas aos diferentes graus de fibrose de Symmers nos pacientes.

OBJECTIVE: To investigate the serum levels of IL-10 and IL-13 in patients with hepatosplenic schistosomiasis mansoni (HSM), evaluating the role of these cytokines in the development of hepatic fibrosis. METHODS: The study was prospective and analytical, developed at the Department of Surgery, Federal University of Pernambuco, Keizo Asami Laboratory of Immunology. We studied three groups: Group I - 25 patients with hepatosplenic schistosomiasis mansoni who were not submitted to surgery; Group II - 30 individuals who underwent splenectomy and ligature of left gastric vein; Group III - 33 subjects without hepatosplenic schistosomiasis mansoni or any other disease or condition that could compromise the hepatic functional reserve. Serum concentrations of IL-10 and IL-13 were obtained through ELISA. Considering their non-parametric nature, all concentrations were analyzed by Kruskal-Wallis test, with p<0.05 used to reject the null hypothesis. RESULTS: The mean concentrations of IL-10 in ng/mL in serum were GI: 50.0 ± 59.0; GII: 38.0 ± 270; GIII: 38.0 ± 20.0. Concentrations of IL-13 in ng/mL in the serum of patients were respectively: 41.0 ± 93.0 in GI, 16.0 ± 17.0 in GII and 18.0 ± 34.0 in GIII. There was no significant difference between the mean concentrations of IL-10 and IL-13 between the study groups (p> 0.05). CONCLUSION: The mean serum concentrations of IL-10 and IL-13 were similar in all three groups, indicating that possibly the presence of these cytokines in serum is not associated with different degrees of Symmers fibrosis in patients with hepatosplenic schistosomiasis mansoni.

Correlation of biological serum markers with the degree of hepatic fibrosis and necroinflammatory activity in hepatitis C and schistosomiasis patients

Liver biopsy is the gold-standard method to stage fibrosis; however, it is an invasive procedure and is potentially dangerous. The main objective of this study was to evaluate biological markers, such as cytokines IL-13, IFN-ã, TNF-á and TGF-â, platelets, bilirubins (Bil), alanine aminotransferase (ALT) and aspartate aminotransferase (AST), total proteins, ã-glutamil transferase (ã-GT) and alkaline phosphatase (AP), that could be used to predict the severity of hepatic fibrosis in schistosomiasis and hepatitis C (HC) as isolated diseases or co-infections. The following patient groups were selected: HC (n = 39), HC/hepatosplenic schistosomiasis (HSS) (n = 19), HSS (n = 22) and a control group (n = 13). ANOVA and ROC curves were used for statistical analysis. P < 0.05 was considered significant. With HC patients we showed that TNF-á (p = 0.020) and AP (p = 0.005) could differentiate mild and severe fibrosis. With regard to necroinflammatory activity, AST (p = 0.002), ã-GT (p = 0.034) and AP (p = 0.001) were the best markers to differentiate mild and severe activity. In HC + HSS patients, total Bil (p = 0.008) was capable of differentiating between mild and severe fibrosis. In conclusion, our study was able to suggest biological markers that are non-invasive candidates to evaluate fibrosis and necroinflammatory activity in HC and HC + HSS.

Níveis séricos de globulinas e a intensidade da fibrose hepática em pacientes com esquistossomose mansônica / Serum globulin levels and intensity of hepatic fibrosis in patients with mansonic schistosomiasis

CONTEXTO: Tem sido descrita correlação entre os níveis séricos de globulinas e o grau de fibrose hepática nas hepatites crônicas, mas não se encontram relatos na esquistossomose mansônica. OBJETIVO: Avaliar os níveis séricos de globulinas e de IgG, e a intensidade da fibrose periportal mensurada pela ultrassonografia em pacientes com esquistossomose mansônica. MÉTODOS: Entre novembro de 2006 e fevereiro de 2007, foram estudados 41 pacientes que preencheram ficha clínica e realizaram dosagens de IgG por imunoturbidimetria e de globulinas indiretamente pelo método do biureto. A ultrassonografia foi realizada por um único pesquisador, seguindo os protocolos do Cairo e de Niamey. RESULTADOS: A média de idade foi 41 anos, sendo 25 pacientes (61 por cento) do sexo feminino. Dez dos 41 pacientes (24 por cento) apresentaram elevação dos níveis séricos de globulinas e 21 (51 por cento) dos de IgG. Conforme a classificação do Cairo, 21 pacientes apresentaram grau I de fibrose, 18 grau II e 2 grau III, e pela classificação de Niamey 8 apresentavam padrão C, 20 D e 13 E. Aqueles com graus II ou III de fibrose tiveram maiores níveis de IgG do que os de grau I (P = 0,047), assim como aqueles que apresentaram padrões D e E em relação ao C (P = 0,011). Não houve associação entre os níveis de globulinas e o grau ou padrão de fibrose. CONCLUSÃO: Em pacientes com esquistossomose mansônica, observou-se elevação dos níveis séricos de IgG de acordo com a progressão do grau e do padrão de fibrose periportal, mas o mesmo não se observou com os níveis de globulinas.

BACKGROUND: A correlation between the levels of serum globulins and the hepatic fibrosis degree in chronic hepatitis was described, but reports in schistosomiasis mansoni have not been found. OBJECTIVE: To evaluate the serum globulins and IgG levels, and periportal fibrosis intensity measured by ultrasound in patients with schistosomiasis mansoni. METHODS: Between November, 2006 and February 2007, 41 patients which were eligible, filled them a questionnaire and had their levels of serum IgG measured by immunoturbidimetry and globulins indirectly measured by the Biuret method. The ultrasound was carried out by a single researcher, according to the Cairo and Niamey protocols. RESULTS: The average age was 41 years old and 25 female patients (61 percent). Ten patients (24 percent) from 41 showed serum globulins levels raised and 21 (51 percent) presented elevated IgG levels. According to the Cairo classification, 21 patients showed grade I of fibrosis, 18 grade II and 2 grade III; and by the Niamey classification 8 showed standard C, 20 D, and 13 E. Those with grade II or III of fibrosis had higher IgG levels than the ones with grade I (P = 0,047), as well as those who showed standards D and E as compared to C (P = 0,011). There was no association between the globulins levels and the intensity of fibrosis. CONCLUSION: In patients with schistosomiasis mansoni, an increase of the IgG serum levels was observed according to the progression from periportal fibrosis intensity, but the same was not founded with globulins levels.

Alteraciones hepáticas en la Leishmaniasis Visceral (Kalazar) en niños: revisión sistemática de la literatura / Liver injury in visceral Leishmaniasis in Children: systematic review

La Leishmaniasis Visceral o Kalazar es una infección parasitaria causada por subespecies del género Leishmania donovani y transmitida por insectos flebotomíneos. Puede evolucionar con compromiso hepático caracterizado por citólisis severa, colestasis, hipertensión portal, hepatomegalia persistente y fibrosis hepática. Estos tipos de presentaciones dificultan el diagnóstico y agravan el pronostico. Se admite que la extensión y frecuencia de este compromiso hepático han sido poco evaluados. Objetivo: Sistematizar las alteraciones hepáticas de Kalazar en la infancia descritas en relatos de casos publicados. Metodología: revisión sistemática de la literatura utilizando las bases de datos LILACS, MEDLINE y EMBASE. Se incluyeron artículos en portugués, español, inglés y francés. Se siguieron los procedimientos de revisión sistemática recomendados por el NHS Centre for Reviews and Dissemination, University of Cork. La clasificación de los artículos (relatos de casos) se basó en la cantidad de información de cada relato de caso en relación a las variables previamente sistematizadas en este estudio. Resultados: 11 (un 55%) artículos fueron incluidos abarcando 28 relatos de casos. La albúmina sérica y el tiempo de protrombina mostraron una asociación con la evolución de la enfermedad: (p = 0,05). Conclusiones: el compromiso epático, incluso grave, puede ocurrir al inicio de la enfermedad. El Kalazar debe ser considerado en el diagnóstico diferencial de hepatitis asociadas a fiebre prolongada, así como en síndromes colestásicos en la infancia en áreas endémicas para la enfermedad.

Visceral Leisshimaniosis or Kalazar is a parasitic infection caused by Leishimania Donovani subspecies. It is transmitted by phlebotomineos and may lead to liver and spleen enlargements as well as immunological impairment. Sometimes it is described liver injury simulating acute or chronic viral hepatitis and even portal hypertension. The liver injury makes difficult the diffencial diagnosis of Kalazar and other liver diseases in endemic regions. Objective: To define and clarify the liver injury spectrum described in published cases reports. Methods: Systematic revision of published data on Kalazar and liver injury, using the following databank: LILACS, MEDLINE and EMBASE. Only paper published in French, English, Portuguese and Spanish were taken into consideration. The procedures for systematic review recommended by the NHS Centre for Reviews and Dissemination, University of Cork, were adopted. The paper quality classification was based on the number of reported variables previously defined in our study. Results: Only 11/ 28 (55%) publications were includedin our analysis because they filled the minimal required data. Acute and chronic liver disease were well documented in these articles. Serum albumin and prothombine time were associated with severity of liver disease (P< .05). Conclusion: “Liver involvement, even when it is severe, may occur at tha begining of the disease. Kalazar should be considered as a differential diagnosis of cholestasis, acute and chronic liver injury, as well as portal hypertension in children.

Ultrasonographic and portal hemodynamic changes in hepatic schistosomiasis patients after treatment with praziquantel

The study included 40 schistosomal cases that divided into 2 groups: Group I [with early schistosomal hepatic fibrosis], and group II [with late schistosomal hepatic fibrosis]. Abdominal and duplex-Doppler ultrasound changes were studied for every case before and 6 months after PZQ therapy in a single dose of 60 mg/kg. In group I, portal vein diameter was significantly reduced after therapy, while group II showed insignificant change. Patients with periportal fibrosis grade 1 and grade 2 showed significant decrease in the degree of fibrosis in group I and no significant difference was recorded in group II. Hepatic fibrosis grade 3 showed no significant change. Duplex-Doppler study showed significant increase in maximum and mean velocity of blood flow in portal vein after praziquantel in group I but no significant change in group II. Accordingly, it was concluded that praziquantel may result in reversal of periportal fibrosis especially in early stage after schistosomal infection

Alterations in serum triacylglycerol, cholesterol and lipoproteins fractions in rabbits suffering from chronic hepatic coccidiosis

The effects of chronic hepatic coccidiosis on serum triacylglycerol, cholesterol, high density lipoproteins [HDL], low density lipoproteins [LDL] and very low density lipoproteins [VLDL] were studied in rabbits experimentally infected with Eimeria stiedae. Twenty coccidia-free New Zeal and males 2-3 months of age were used. The animals were divided into two equal groups. The animals in group I [control group] were not infected. Group II was infected by 6000 sporulated oocysts of Eimeria stiedae per rabbit through oral route. Blood samples were collected at 45 days post infection. The statistical analysis revealed that the triacylglycerol, cholesterol, HDL, LDL, and VLDL were highly significantly decreased in rabbits infected with Eimeria stiedae

value of fructosamine in monitoring diabetes control in NIDD with different stages of schistosomal liver disease

The value of fructosamine versus glycosylated hemoglobin HbA[1c] in monitoring diabetes control in diabetics with different stages of liver disease was investigated. The study included diabetics without liver disease [[Group I, n = 20], diabetics with compensated hepatosplenic schistosomiasis [HSS] [Group II, n = 20], diabetics with decompensated HSS [Group III, n 20]. Each group included patients who were controlled [n = 10] and others who were uncontrolled [n = 10] for at least 2 months before the stud. Group IV included 10 normal controls, 10 with compensated HSS and 10 with decompensated HSS without diabetes. Both HbA[1c] and fructosamine were determined by quantitative colorimetry. In diabetics without liver disease both fructosamine and HbA[1c] correlated significantly with plasma glucose was well as with each other and so fructosamine which is cheaper can be used alone for monitoring diabetes control in such cases. In the absence of diabetes fructosamine decreased in parallel with the progress of liver disease while HbA[1c] did not change. This illustrates the influence of decreasing albumin in fructosamine levels. Fructosamine was not correlated to HbA[1c] but was correlated to albumin. In diabetics with liver disease, fructosamine and HbA[1c] levels followed the same pattern as in patients without diabetes indicating that fructosamine levels are related more to albumin than the glucose levels. It can be concluded that fructosamine can be used safely for monitoring diabetes control in the absence of liver disease, while HbA[1c] is preferred with liver disease

First time description of eosinophilic changes in human hepatic fascioliasis

Eosinophil size and morphology were studied in 200 patients with parasitologically diagnosed hepatic fascioliasis. It was found that the mean size of peripheral blood eosinophil was increased [23 +/- 9] in 96% of patients and that the increase was proportionate with the egg output. Moreover, patients with mixed infection with F. hepatica and F. gigantica, had on the average, larger eosinophil than those with single infection. Changes in eosinophil nuclei were also encountered. They were in the form of polymorphic pattern as stab, ring shaped, bilobed, trilobed and tetralobed appearances. Nuclear polymorphism was more frequently encountered in patients with high egg output and in patients with F. gigantica than those with F. hepatica. Eosinophil cytoplasm had also shown increase in the size of eosinophilic granules in 67% of patients, clear cytoplasmic vacuoles in 68% and basophilic granules in 32%. Such changes were more frequently encountered in patients with high egg output. Such changes; in eosinophil were not previously described in human hepatic fascioliasis

Serum type III procollagen peptides in patients with hepatointestinal and compensated hepatoesplenic schistosomiasis forms

Os níveis dos peptídios séricos do procolágeno tipo III (PSPC III) foram determinados em 35 indivíduos: 25 esquistossomóticos näo tratados da parasitose, sendo 16 da forma hepatointestinal (HI) e nove da hepatoesplênica compensada (HEC) e dez sadios. Para a dosagem dos PSPC III foram utilizados kits de radioimunoensaio. Procurou-se demonstrar a correlaçäo entre os níveis dos PSPC III e as atividades séricas das enzimas aminotransferase da alanina (ALT), aminotransferase do aspartato (AST), fosfatase alcalina (FA) e gamaglutamiltranspeptidase (GGTP). As médias dos valores dos PSPC III nas formas HI (13 ng/ml) e HEC (17 ng/ml) foram significantemente maiores do que as do grupo controle (9,0 ng/ml) (p < 0,05). Näo se observou diferença significante quanto aos valores dos PSPC III entre os grupos de pacientes das formas HI e HEC. Näo houve correlaçäo entre os aumentos dos PSPC III e os da atividade sérica da ALT, AST, FA e GGPT. Os autores discutem aspectos sobre eventual aplicabilidade da determinaçäo dos PSPC III em pacientes com esquistossomose

Effect of experimental Schistosomiasis on 14C-4-cholesterol esterification by mouse liver homogenate

The effect of experimental schistosomiasis mansoni on cholesterol esterification by mouse liver homogenate was studied using 14C-4-cholesterol. The reaction was carried out in 0.85 ml containing 10 nCi labelled cholesterol (I64 nmol as an albumin-stabilized emulsion) with 30 mg tissue homogenate in 176 mM sodium phosphate buffer, pH 7.1, containing 59 micronM oleic acid, 0.3 mM CoASH and 8.8 mM ATP. In experiments with liver from infected mice(N = 22), the percentage of cholesterol esterification was 6.9 + or - 0.7%/h. This rate was 52% less than that observed in normal mice (14.4 + or - 0.6%/h, N = 21). The decrease may be due to the existence of inhibitors of the cholesterol esterifying in the infected liver, increased hydrolysis of cholesteryl esters or a decrease in the synthesis of the enzyme acyl CoA:cholesterol acyl transferase by the infected liver

Avaliaçäo da funçäo hepática de síntese protéica na hepatopatia esquistossomótica compensada e na cirrose / Evaluation of the hepatic function of protein synthesis in compensated schistosomotic hepatopathy and cirrhosis

A funçäo hepática de síntese protéica foi avaliada por meio da determinaçäo da concentraçäo sérica de albumina, de transtiretina e da proteína de ligaçäo do retinol (PLR), em portadores de hepatopatia esquistossomótica compensada e em cirróticos. Verificou-se que: a) em hepatopatia crônica e estável a meia-vida biológica de uma proteína näo deve ser o fator determinante de sua concentraçäo sérica, pois a PLR (meia-vida de 12h) mostrou-se normal em doentes com hipoalbuminemia (meia-vida de 21 dias) e/ou hipotranstiretinemia (meia-vida de 2 dias); b) na hepatopatia esquistossomótica a hipoalbuminemia pode refletir, em alguns doentes, näo insuficiência de síntese, mas sim o grau de hiperglobulinemia; c) a determinaçäo simultânea da concentraçäo sérica de albumina e transtiretina é mais útil na avaliaçäo de hepatopatias crônicas do que a determinaçäo de uma ou outra isoladamente; d) a determinaçäo da PLR nada acrescenta às informaçöes já obtidas com a determinaçäo de albumina e transtiretina séricas

Alfafetoproteína na esquistossomose mansônica / Alpha fetoprotein in schistosomiasis mansoni

A concentraçäo plasmática da alfafetoproteína (AFP), que aumenta consideravelmente em hepatomas, assim como em tumores de outros tecidos, pode também elevar-se, moderadamente, em hepatopatias näo neoplásicas, tanto agudas como crônicas. Neste trabalho verificamos que a AFP é normal em indivíduos (näo alcoólatras e HBsAg negativos) portadores da forma hepatosplênica e compensada da esquistossomose mansônica. Portanto, a hepatopatia esquistossomótica, per se, näo parece ser causa de elevaçäo do nível plasmático da AFP; deste modo, um aumento neste nível poderá significar, em portadores desta hepatopatia, superposiçäo de outra patologia, neoplásica ou näo

Hiperatividade do fator VII no plasma de portadores de hepatopatia esquistossomótica / Hyperactivity of factor VII in the plasma of schistosomotic hepatopathy patients

Aproximadamente 15% dos indivíduos normais säo "ativadores" em relaçäo ao fator VII da coagulaçäo, isto é, em seu plasma, quando submetido ao frio, há uma ativaçäo "ex vivo" deste fator. Verificamos que cinco de 37 portadores de hepatopatia esquistossomótica (13,5%) eram "ativadores" do fator VII. Esse fato precisa ser considerado quando o fator VII for usado para avaliaçäo da capacidade hepatocelular de síntese protéica em portadores de hepatopatia esquistossomótica