Clinical usefulness of acid steatocrit in pediatric practice.

The steatocrit technique has been frequently used in the follow up of malabsorption syndromes. The classical steatocrit method has recently been improved by adding perchloric acid to the fecal homogenate (acid steatocrit), this technique showed a better correlation with fecal fat concentration than the classical test. In our protocol, we aimed at an assessment of the clinical usefulness of the acid steatocrit when compared to the traditional technique. Children who were referred to the laboratory for evaluation of steatorrhea were studied by the fecal fat balance, which was taken as a gold standard method for the comparison between both steatocrits. The method was slightly modified, by using hydrochloric instead of perchloric acid. Our results showed a sensitivity of 88.8% for the acid steatocrit and 66.7% for the classical method, at a 1.6% cut off value. We suggest the method as useful to rule out steatorrhea, thus selecting those children who should not be submitted to more laborious and time consuming methods such as the fecal fat balance.

A patient with hepatitis B, antimicrosomal antibodies, and autoimmune hypothyroidism.

A 37-year-man with chronic hepatitis B was diagnosed as having antimicrosomal antibodies and subclinical hypothyroidism. The association of autoimmune manifestations with hepatitis B has been less frequently reported than with hepatitis C virus. It is discussed whether this patient illustrates a case of spontaneous development of antimicrosomal antibodies, only casually associated with the presence of hepatitis B virus, or there is a real causative relationship between both conditions.

Inguinal hernia incarceration as a form of intestinal tuberculosis.

We report the case of a 41 year-old male who came to the emergency room with a complaint of abdominal pain, and was diagnosed to have an acute obstructive abdomen due to a right inguinal hernia incarceration. During surgery, an intestinal granulomatous inflammation was observed adhered to the hernial sac. The histopathologic study confirmed the diagnosis of tuberculosis. We present a review of the different clinical forms of intestinal tuberculosis and the difficulties encountered in the differential diagnosis of such, emphasizing the uncommon presentation described in our patient.

Parasite and egg burden, hepatic collagen and histologic pattern of liver granulomas in selection III high and low antibody responder mice infected with Schistosoma mansoni

Selection III mice have particular immunological characteristics: they are high (H III) or low (L III) antibody producer animals, yet both lines display similar T cell responses and macrophage activities. We submittedthese mice to infection with Schistosoma mansoni to assess in vivo parasite and egg burden, hepatic collagen and cellular composition of granulomas in both lines. Titration of anti-Schistosoma IgG by ELISA showed remarkably higher values inH III line, at both studied periods (8th and 12th weeks post-infection). Nevertheless, the number of adult worms recovered from the portal system was similar inboth lines, being not associated with anti-Schistosoma antibody levels. There isan increase in hepatic collagen from the 8th to the 12th weeks post-infection, which is paralleled by an increase in the number of eggs in the liver. This association apparently occurs at the same radio in H III and L III animals. The most important difference found between the two lines was the outstanding contrast interms of volume and eosinophil counts in the granulomas, with lesions from H IIImice clearly being larger and containing more of these cells than LIII lesions

Parasite and egg burden, hepatic collagen and histologic pattern of liver granulomas in selection III high and low antibody responder mice infected with Schistosoma mansoni.

Selection III mice have particular immunological characteristics: they are high (H III) or low (L III) antibody producer animals, yet both lines display similar T cell responses and macrophage activities. We submitted these mice to infection with Schistosoma mansoni to assess in vivo parasite and egg burden, hepatic collagen and cellular composition of granulomas in both lines. Titration of anti-Schistosoma IgG by ELISA showed remarkably higher values in H III line, at both studied periods (8th and 12th weeks post-infection). Nevertheless, the number of adult worms recovered from the portal system was similar in both lines, being not associated with anti-Schistosoma antibody levels. There is an increase in hepatic collagen from the 8th to the 12th weeks post-infection, which is paralleled by an increase in the number of eggs in the liver. This association apparently occurs at the same ratio in H III and L III animals. The most important difference found between the two lines was the outstanding contrast in terms of volume and eosinophil counts in the granulomas, with lesions from H III mice clearly being larger and containing more of these cells than LIII lesions.

Murine schistosomiasis mansoni: estimation on some immunohistological parameters of small bowel granulomas and renal parenchyma.

One hundred and twenty five mice were divided into three groups: uninfected (I), and infected with 30 (II) and 60 (III) cercariae. Jejunal, ileal and renal sections were analyzed by direct immunofluorescence technique, aiming the detection of gamma globulins and complement C3. Intestinal sections were also stained by hematoxylin-eosin, during some periods of disease. The cellular composition of the jejunal and ileal granulomas seemed very similar, with many eosinophils and an increased number of mononuclear cells later on. The histological evaluation of these sections showed that the ileum may hold greater number of eggs, possibly being more affected than the jejunum. The results also suggest a mixed mechanism to the formation of intestinal granulomas, both cell and antibody mediated.