Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038002 (splenomegaly)
 9,873 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hemostasis was studied in 18 patients with the hepato-intestinal form of Schistosomiasis mansoni and in 23 with the hepato-splenic form. Both groups are compared referring to alterations found. The relations between plasmatic coagulation factors and hepatocytic function tests are studied. In 6 patients the explorations were repeated after administration of hycanthone. In the patients with the hepato-splenic form, the presence of chronic consumptive coagulophathy was found. The coagulopathy disappeared either by treatment with heparine or by splenectomy. This observation points out the importance of splenomegaly in the development of chronic consumptive coagulopathy, and may be an important factor in indicating splenectomy in a patient with portal hypertension due to Schistosomiasis mansoni.
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PMID:Hemostasis in schistosomiasis mansoni. 9 24

A study of morbidity in Schistosoma mansoni infection was made in 593 Sudanese patients seen in a four-year period in Khartoum Civil Hospital. Clinical and laboratory findings were compared in three egg-count groups and in four clinical forms of the infection. Patients were divided into three levels of intensity of infection: light (up to 100 eggs/gram of stool), moderate (101--400 eggs/g) and heavy (more than 400 eggs/g). According to the presence or absence of visceral enlargement, infected subjects were divided into one of four clinical forms: intestinal, hepatic, hepatosplenic and splenic. Among the symptoms only the passage of blood in the stools was significantly related to intensity of infection, and fever was significantly related to the presence of hepatosplenic disease. Hepatomegaly and splenomegaly were significantly more frequent in the heavy infection group. Anaemia, eosinophilia, raised ESR and an increase in both serum alkaline phosphatase and serum globulins were significantly related to the intensity of infection. On the other hand, haematological and biochemical changes, as well as histopathological changes, were more marked and severe in patients with hepatosplenic disease. For comparison, the findings of 117 patients with S. haematobium infections and of 41 with dual S. mansoni/S. haematobium infections are included.
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PMID:Morbidity in relation to the clinical forms and to intensity of infection in Schistosoma mansoni infections in the Sudan. 53 48

To determine whether chronic Schistosoma mansoni infection interferes with hepatitis B virus (HBV) immunization, 308 schoolchildren aged 6-12 years with no evidence of prior HBV infection (156 with active schistosomiasis) were vaccinated with three 5-micrograms injections of recombinant DNA-derived HBV vaccine. The vaccine was given in the deltoid muscle at time 0 and 1 and 7 months later. All vaccinees were examined 1 and 3 years after vaccination for quantitative antibody to hepatitis B surface antigen (anti-HBs). Seroconversion was detected in 284 vaccinated children (92%), of whom 271 had a good (51-300 mIU/mL) or excellent (greater than 300 mIU/mL) anti-HBs response. Sixteen other children (5%) had evidence of natural HBV infection (antibody to hepatitis B core antigen). Of those with good or excellent response, 99% retained high antibody titers for 3 years. Response was not influenced by S. mansoni infection. Hepatomegaly and splenomegaly were associated with reduced vaccine response.
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PMID:Efficacy of hepatitis B vaccination in primary school children from a village endemic for Schistosoma mansoni. 138 97

Twenty-seven Brazilian and 32 Sudanese patients with hepatosplenic schistosomiasis from areas where the disease is endemic were examined with ultrasound (US). Hyperechoic periportal areas indicating periportal fibrosis (PPF) were present in all patients irrespective of their origin. Nonspecific findings were splenomegaly (all patients), gallbladder wall thickening (81% and 92%, respectively, in Brazilian and Sudanese patients), portal vein (74% and 87%, respectively) and splenic vein (59% and 70%, respectively) enlargement, and portosystemic vascular shunts (62% and 61%, respectively). The hepatic alterations were congruent and the frequency of their occurrence was similar in both patient groups. With a standardized grading system, it was shown that grade of PPF was significantly correlated with a history of bleeding from endoscopically proved esophageal varices and with distention of the portal vein as measured with US. It was concluded that sonographic grading may be used in patients with hepatosplenic Schistosoma mansoni infection who originate from completely different endemic areas.
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PMID:Hepatosplenic schistosomiasis: comparison of sonographic findings in Brazilian and Sudanese patients--correlation of sonographic findings with clinical symptoms. 150 54

In February 1987, 322 Sudanese school children were diagnosed for Schistosoma mansoni infection and treated randomly with praziquantel (either 20 mg/kg or 40 mg/kg body weight). A followup of these subjects was carried out in January 1989. This treatment resulted in a substantial reduction of egg output. Patients underwent complete abdominal ultrasonography and periportal fibrosis of the liver was graded into three degrees of severity. The proportion of patients with periportal fibrosis decreased from 36.6% in February 1987 to 21.7% in January 1989. At the time of followup, higher grades of periportal fibrosis (grades II and III) were encountered in only 4.3% and 0.3% of these patients, respectively, compared with 21.1% and 5.9%, respectively, before therapy. This was paralleled by a significant decrease in hepatomegaly from 10.9% to 7% of the patients. In contrast, the rate of splenomegaly showed a slight increase during the period of observation. The different dosage regimens of praziquantel did not result in a significantly different reversibility of periportal fibrosis or a decrease in egg excretion. The reversibility of specific liver lesions 23 months after antischistosomal therapy with praziquantel was substantial. The improvement was greater at 23 months than that obtained seven months after treatment.
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PMID:Ultrasonographical investigation of periportal fibrosis in children with Schistosoma mansoni infection: reversibility of morbidity twenty-three months after treatment with praziquantel. 157 87

The relationship between intensity of Schistosoma mansoni infection and the degree of related morbidity was suspected to differ locally within the Machakos district of Kenya. To test this possibility, prevalences of hepatomegaly and splenomegaly among 1483 school children were compared between 2 areas, Kangundo and Kambu, within this district. These areas, which were similar in many geographical and economic respects and populated by the same tribe (Akamba), had comparable levels of S. mansoni infection and no S. haematobium infection. A relationship was observed between the prevalence of hepatomegaly and intensity of S. mansoni infection, which showed no consistent difference between the 2 areas. In contrast, a relationship between the prevalence of splenomegaly and intensity of S. mansoni infection was observed only in the Kambu schools, and not in the Kangundo schools where the overall prevalence of splenomegaly was much lower. It was possible that part of the splenomegaly observed in Kambu was due to malaria. However, the observation that malaria and schistosomiasis in 2 Kambu schools were not positively correlated allowed approximations to be made of the relative contributions of each to the prevalence of splenomegaly. It was concluded that, in a school close to the river that formed the main transmission site of S. mansoni, schistosomiasis-related hepatosplenomegaly was present in at least 17% of children. The reason for the high prevalence in Kambu of hepatosplenic schistosomiasis remains uncertain, but it could include a synergistic interaction of schistosome infection with malaria.
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PMID:Differences in the rate of hepatosplenomegaly due to Schistosoma mansoni infection between two areas in Machakos District, Kenya. 175 56

Five hundred thirty six Sudanese schoolchildren with Schistosoma mansoni infection were treated at random with either 20 mg or 40 mg/kg praziquantel. Seven months later 420 children could be reinvestigated by ultrasonography. Reduction of egg excretion and reversibility of sonographically-proven periportal fibrosis (PF) was not significantly different in the two groups. Schistosoma mansoni-induced PF grade II decreased from 22.9% to 6.7% and grade III from 5.2% to 1.6%. An increased prevalence of PF grade I, from 10% to 29.8% of the investigated patients, was observed. This increase was caused partly by a downshifting of patients who had PF II (n = 45) and PF III (n = 8) before therapy, but also by patients who developed PF I in the seven months after therapy (n = 56). The overall percentage of patients with PF before and after treatment was 38.1%. Of 420 children, 17.4% increased in their PF grade, 55% remained at the same level and 27.6% improved. Children younger than 11 years of age had a higher rate of complete reversibility than older ones. The percentage of patients with hepatomegaly decreased significantly (11.6% to 6.9%; p = 0.001). The rate of splenomegaly remained unchanged. It was concluded that within seven months therapy with praziquantel resulted in a considerable qualitative improvement of PF in Sudanese schoolchildren with S. mansoni infection.
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PMID:Ultrasonographical investigation of periportal fibrosis in children with Schistosoma mansoni infection: reversibility of morbidity seven months after treatment with praziquantel. 190 98

A cross-sectional study of morbidity associated with Schistosoma mansoni infection in an area in North-East Brazil where the disease is endemic was carried out in 1974. The survey was repeated in 1977, before mass treatment with oxamniquine, providing a cohort of 210 individuals who had both examinations. The high prevalence of hepatomegaly (over 80%) and of splenomegaly (over 15%) contrasted with rates of 10% and 1%, respectively, in a non-endemic area. Over the 3-year period hepatomegaly spontaneously regressed in 13% of patients, and splenomegaly regressed in 56%, a phenomenon most common in older individuals with light infections. Those with heavy infections--ie, 500 or more eggs per g faeces, had an excess risk of splenomegaly of 19.6% and, of its persistence, of 61.5%. Thus, intensity of infection was a critical factor in liver and spleen involvement, and programmes of chemotherapy that reduce infection should mitigate the risk of schistosomal morbidity.
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PMID:Three-year prospective study of the evolution of Manson's schistosomiasis in north-east Brazil. 286 24

A study was carried out in Comercinho in south-east Brazil where information relating to socioeconomic factors and water contacts was obtained from 290 (99% of the total) households and 1208 (82% of the total) inhabitants, respectively. Stool examinations and physical examinations were performed on 90% and 82% of the population, respectively. The rates of Schistosoma mansoni infection and splenomegaly were higher in families whose heads were manual workers, in individuals living in houses without piped water and of poor construction, and in those who were born in Comercinho. A total of 1017 (84%) individuals reported water contact; 75% of these contacts were for household activities or bathing and 21% for leisure. The faecal egg counts decreased in persons over 15 years of age, while the degree (intensity) of water contact did not. The mean degree of water contact was higher in individuals without than with piped water in the household (96.8+/-0.6 v. 25.7+/-0.6). The main risk factors for splenomegaly weer no piped water, intense water contact, bathing in streams, and daily contact (odds ratio=7.3, 5.1, 4.5 and 3.6, respectively). These results indicate that the extension of piped water to houses should decrease the incidence of splenomegaly in this endemic area.
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PMID:Water-contact patterns and socioeconomic variables in the epidemiology of schistosomiasis mansoni in an endemic area in Brazil. 310 47

A cross-sectional study was made of the morbidity due to Schistosoma mansoni infection in the Rusizi plain, Burundi. An evenly distributed 5% population sample (n = 6203) was examined; each subject was submitted to a standardized medical history and abdominal palpation. The prevalence of infection was 33% and most infections were light. Diarrhoea was complained of by 26% of those infected and 21% of those not infected; "bloody diarrhoea" by 13% and 4%, respectively. The association with schistosomiasis was significant in all age groups. "Abdominal pain" was a very common complaint, "tiredness" an infrequent one; neither was associated with the infection. Left lobe hepatomegaly was found in 26% of those infected, and in 10% of those not infected; right lobe hepatomegaly in 7% and 5%, and splenomegaly in 30% and 24%, respectively. The frequency of organomegaly and its association with schistosomiasis was maximal in children, decreased in adolescents and young adults, and increased again in older adults; its intensity was generally mild. Ascites or histories of haematemesis were not recorded, though several cases of decompensated portal hypertension due to schistosomiasis have been documented at the central hospital of Bujumbura. The relation of morbidity to intensity of infection was limited to a correlation between hepatomegaly and egg load in those over 40 years old. It is concluded that, in this situation, selective mass treatment is a better strategy than targeted or selected group chemotherapy.
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PMID:The morbidity of schistosomiasis mansoni in the Rusizi Plain (Burundi). 315 15


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