Anicteric cholangiopathy in schistosomiasis patients
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Data
2008-11-01
Autores
Brant, Paulo Eugenio [UNIFESP]
Aguiar, Luciane Aparecida Köpke de [UNIFESP]
Shigueoka, David Carlos [UNIFESP]
Sales, Danilo [UNIFESP]
D'Ippolito, Giuseppe [UNIFESP]
Kouyoumdjian, Maria [UNIFESP]
Borges, Durval R. [UNIFESP]
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We previously reported that in anicteric patients with the isolated form of schistosomiasis (without comorbidities) an ursodeoxycholic acid-sensitive increase in serum gamma-glutamyltransferase activity (gamma GT) occurs. We now describe the presence of cholangiopathy in these patients.Methods: Sixteen adult anicteric patients with the isolated form of schistosomiasis mansoni were carefully selected: nine with increased gamma GT and seven with normal gamma GT. High sensitive C-reactive protein (CRP), to exclude inflammatory status, hyaluronic acid (HA), and other laboratory parameters were determined. the ultrasonographic study measured spleen length, portal vein and splenic vein diameters, and the portal flow. Magnetic resonance cholangiopancreatography (MRCP) images were interpreted by a blind observer. MRCP was deemed abnormal when focal narrowing and/or paucity of second and third order biliary branches and/or irregularities in the contours of biliary pathways were identified.Results: Both groups (normal and elevated gamma GT) have preserved hepatic function tests (HA, serum albumin, prothrombin time) and clinical significant portal hypertension (low platelet count and ultrasonographic parameters). MRCP was abnormal in all patients with elevated gamma GT but in only 3 of the 7 patients with normal gamma GT (p = 0.003).Conclusion: Magnetic resonance cholangiopancreatography characterized a cholangiopatic disorder in anicteric patients with the isolated form of schistosomiasis, even preceding laboratory test alterations. (c) 2008 Elsevier B.V. All rights reserved.
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Acta Tropica. Amsterdam: Elsevier B.V., v. 108, n. 2-3, p. 218-221, 2008.