Clinical and ultrasound findings before and after praziquantel treatment among Venezuelan schistosomiasis patients Achados clínicos e no ultra-som pré e pós tratamento com praziquantel em pacientes venezuelanos com esquistossomose
Abdominal ultrasound can be a useful tool for diagnosing periportal fibrosis related to Schistosoma mansoni infection, and also for planning and monitoring the evolution of hepatic morbidity following control measures. We evaluated the standardized ultrasound methodology proposed by the World Health...
| Published in: | Revista da Sociedade Brasileira de Medicina Tropical |
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| Main Authors: | , , , , , |
| Format: | Article in Journal/Newspaper |
| Language: | English |
| Published: |
Sociedade Brasileira de Medicina Tropical (SBMT)
2007
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| Subjects: | |
| Online Access: | https://doi.org/10.1590/S0037-86822007000500003 https://doaj.org/article/8620f79b7bc24b74a77b7a63dd697d94 |
| Summary: | Abdominal ultrasound can be a useful tool for diagnosing periportal fibrosis related to Schistosoma mansoni infection, and also for planning and monitoring the evolution of hepatic morbidity following control measures. We evaluated the standardized ultrasound methodology proposed by the World Health Organization for detecting periportal fibrosis and portal hypertension, among patients from an endemic area in Venezuela, and the impact of praziquantel treatment 3-5 years later. After chemotherapy, complete reversal of periportal lesions was observed in 28.2% of the cases and progression of the disease in 5.1%. Improvement in the hepatic disease started with a reduction in the periportal thickening followed by a decrease in the size of the left hepatic lobe, spleen and mesenteric and spleen veins. Ultrasound confirmed the clinical findings after chemotherapy among the patients with reversal of the disease. However, in patients with more advanced disease, these findings were contradictory. There was no correlation between evolution of the disease seen on ultrasound and age, intensity of infection or serological findings. O ultra-som abdominal pode ser uma ferramenta útil para o diagnóstico da fibrose periportal relacionada à infecção por Schistosoma mansoni, e também para planejar e monitorar a evolução da morbidade hepática após medidas de controle. Nós avaliamos a metodologia padronizada no ultra-som, proposta pela Organização Mundial da Saúde, para a detecção da fibrose periportal e hipertensão porta, em pacientes de área endêmica da Venezuela e o impacto do tratamento com praziquantel 3-5 anos depois. Após quimioterapia, houve reversão completa das lesões periportais em 28,2% dos casos e progressão da patologia em 5,1%. A melhora da patologia hepática começou com a redução do espessamento periportal seguida pela diminuição do tamanho do lobo esquerdo, baço e veias mesentérica e esplênica. O ultra-som confirma os achados clínicos após quimioterapia em pacientes com reversão da patologia; contudo, naqueles com ... |
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