Hiperesplenismo na esquistossomose mansÃnica : o baÃo e as cÃlulas sanguÃneas antes e depois de esplenectomia

AUTOR(ES)

Murilo DÃlia Maia

DATA DE PUBLICAÇÃO

2002

RESUMO

Seventy eight patients with chronic hepatosplenic schistosomiasis underwent left gastric vein ligature and also splenectomy as a complementary measure for treatment of portal hypertension after upper gastrintestinal tract bleeding. Weight and clinical measurements of spleens were taken in order to study their relationship with blood counts, the variability between counts (before and after surgery), and for comparison with normal values. Pactients with associated liver diseases were excluded, as well as other conditions that could modify the blood picture, like recent bleeding episodes or transfusions. The aim of this study was to establish the prevalence of peripheral blood cytopenias and to figure out how the hypersplenism affects blood in the advanced form of schistosomiasis. We deliberately decided to analyze blood counts obtained late after splenectomy, intending to work with a stable situation. Spleen size showed statistical correlation with spleen weight, and the last with leukopenia and thrombocytopenia, despite the fact that spleen size only correlated significantly with leukopenia. Spleenâs weight and size showed a tendency to be reduced as the age increased, however only the weight was statistically related to aging. Cytopenia was found in all patients. Anemia ocurred in 88%, leukopenia in 96% and thrombocytopenia in 87% and no selectivity was showed. Anemia occurred at equal rates for both sexes and revealed carential traits. Leukopenia was due predominantly to linfocytopenia, although it affected all other leukocytes except eosinophils. Platelets were reduced in most cases, but rarely reached alarming numbers. A great proportion of cytopenias were solved following splenectomy. Normal counts were seen in 91% of the patients in the case of leukocites and 93% for the platelets. Leukocytosis and throbocytosis were rare after splenectomy and residual cytopenia was barely seen. The red cells numbers were also normal in 74% of the cases, although ferropenic aspects have certainly lowered these results. The study revealed isolated cytopenias are unlikely to occur (1,3 to 4,0%) but they were much more common when paired (any) with 70 to 83%, and that pancytopenia was present in two thirds (67%) of the patients

ASSUNTO(S)

medicina cÃlulas sangÃÃneas baÃo esquistissomose mansÃnica

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