Evaluation of patients with schistosomal portal hypertension treated in a tertiary hospital

Abstract

BACKGROUND: Schistosomiasis is an important public health issue in more than 70 countries around the world. About 600 million people are at risk to acquire the parasite and there are 200 million infected worldwide. AIM: To evaluate the characteristics of schistosomal portal hypertension individuals who underwent previous esophageal varices bleeding treated in a tertiary hospital. METHODS: The records of 155 patients were evaluated and clinical, laboratorial, endoscopic, epidemiological features and hemorrhagic event severity were analyzed to individualize this population. RESULTS: Mean age was 37.2 years and no clinical signs of hepatic failure were observed. Serum laboratory tests to evaluate liver function were normal or slightly alter. Anemia was present in 70 %, leucopenia in 75 % and thrombocytopenia in 86 % of the patients. At endoscopic evaluation varices were classified as grade III and IV in 91.3 %; red spots were observed in 40.3 % and congestive gastropathy in 13.6 %. Patients presented a mean of 2.8 previous episodes of variceal hemorrhage and, in 75 % with hemodynamic instability. CONCLUSIONS: Patients with schistosomal portal hypertension and history of upper digestive bleeding from esophageal varices are young individuals, without either clinical or laboratorial evidence of liver dysfunction, that present high morbidity due to the severity of the acute event of bleeding.

Hepatosplenic Schistosomiasis-Associated Chronic Portal Vein Thrombosis: Risk Factor for Hepatocellular Carcinoma?

“…Studies using portal vein ligation in rats demonstrated a long-term effect of portal flow deprivation on mRNA expression of proliferative and angiogenic factors in the liver, indicating a potential association with liver carcinogenesis 13,14 . Another study showed an association of PVT with the development of liver lesions, including benign liver tumors, such as focal nodular hyperplasia and hepatocellular adenoma, and malignant liver tumors, such as HCC and hepatoblastoma 15,17 .…”