Evaluation of hemostasis disorders and anticardiolipin antibody in patients with severe leptospirosis

Daher, Elizabeth De Francesco; Neto, Francisco Holanda Oliveira; Ramirez, Susana Marcela Pineida

doi:10.1590/s0036-46652002000200006

Cited by 24 publications

(7 citation statements)

References 21 publications

(34 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other reports showed low platelets at admission in almost 95%. 16,28 In the present study, 74% of the patients had platelet count lower than 100,000/mm 3 .…”

Section: Discussionsupporting

confidence: 46%

Clinical presentation of leptospirosis: a retrospective study of 201 patients in a metropolitan city of Brazil

Daher¹,

Lima²,

Júnior³

et al. 2010

Braz J Infect Dis

View full text Add to dashboard Cite

INTRODUCTION: leptospirosis is a zoonosis of worldwide importance. The disease is endemic in Brazil. This study was conducted to describe the clinical and laboratory presentation of leptospirosis in a metropolitan city of Brazil. METHODS: this is a retrospective study including 201 consecutive patients with leptospirosis admitted to tertiary hospitals in Fortaleza, Brazil, between 1985 and 2006. All patients had clinical and epidemiological data suggestive of leptospirosis, and positive laboratorial test for leptospirosis (microscopic agglutination test, MAT, higher than 1:800). RESULTS: a total of 201 patients were included, with mean age of 38.9 ± 15.7 years; 79.1% were male. The mean length from onset of symptoms to admission was 7 ± 3 days. The main clinical signs and symptoms at admission were fever (96.5%), jaundice (94.5%), myalgia (92.5%), headache (74.6%), vomiting (71.6%) and dehydration (63.5%). Hemorrhagic manifestations were present in 35.8%. Acute kidney injury was found in 87% of the patients. Platelet count was less than 100,000/mm³ in 74.3%. Hematuria was found in 42.9%. Death occurred in 31 cases (15.4%). CONCLUSIONS: leptospirosis is a globally relevant disease with potential fatal outcome. Signs and symptoms suggestive of leptospirosis must be known by any physician in order to institute early adequate treatment to improve outcome. Early indication and daily hemodialysis seems to be beneficial in this group of patients

show abstract

“…Other reports showed low platelets at admission in almost 95%. 16,28 In the present study, 74% of the patients had platelet count lower than 100,000/mm 3 .…”

Section: Discussionsupporting

confidence: 46%

Clinical presentation of leptospirosis: a retrospective study of 201 patients in a metropolitan city of Brazil

Daher¹,

Lima²,

Júnior³

et al. 2010

Braz J Infect Dis

View full text Add to dashboard Cite

show abstract

“…Thrombocytopenia in leptospirosis occurs around 50 to 93% of cases and is transient and does not result from disseminated intravascular coagulation 12,20,22 . In the current study, the majority of patients had an important decrease in platelet count.…”

Section: Discussionmentioning

confidence: 99%

“…Bleeding is a common complication in leptospirosis and has become the main cause of death in this disease 12 . Hemorrhage occurred mainly in the respiratory tract.…”

Section: Discussionmentioning

confidence: 99%

“…Leptospirosis is characterized by a broad spectrum of clinical manifestations, which goes from a subclinical infection and self-limited anicteric febrile illness to Weil's disease, a severe and potentially fatal disease characterized by hemorrhage, acute renal failure and jaundice 5,12,20,22 . It can cause diffuse organ involvement due to an extensive vasculitis 20,22 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pancreatic involvement in fatal human leptospirosis: clinical and histopathological features

Daher

Brunetta

Júnior

et al. 2003

Rev. Inst. Med. trop. S. Paulo

Self Cite

View full text Add to dashboard Cite

SUMMARYHyperamylasemia has been reported in more than 65% of patients with severe leptospirosis, and the true diagnosis of acute pancreatitis is complicated by the fact that renal failure can increase serum amylase levels. Based on these data we retrospectively analyzed the clinical and histopathological features of pancreas involvement in 13 cases of fatal human leptospirosis. The most common signs and symptoms presented at admission were fever, chills, vomiting, myalgia, dehydratation, abdominal pain and diarrhea. Trombocytopenia was evident in 11 patients. Mild increased of AST and ALT levels was seen in 9 patients. Hyperamylasemia was recorded in every patient in whom it was measured, with values above 180 IU/L (3 cases). All patients presented acute renal failure and five have been submitted to dialytic treatment. The main cause of death was acute respiratory failure due to pulmonary hemorrhage. Pancreas fragments were collected for histological study and fat necrosis was the criterion used to classify acute pancreatitis. Histological pancreatic findings were edema, mild inflammatory infiltrate of lymphocytes, hemorrhage, congestion, fat necrosis and calcification. All the patients infected with severe form of leptospirosis who develop abdominal pain should raise the suspect of pancreatic involvement.

show abstract

“…Although the cause of leptospirosis hemorrhages is not completely understood, some studies report ongoing fibrinolysis, activation of coagulation, impaired anticoagulation, and thrombocytopenia, whereas the involvement of disseminated intravascular coagulation is controversial (Sitprija et al, 1980; Edwards et al, 1986; De Francesco Daher et al, 2002; Chierakul et al, 2008; Wagenaar et al, 2010; Vieira et al, 2016; Vieira and Nascimento, 2016). Endothelial cell infection and activation has also been implied as a mechanism in leptospirosis hemorrhages, contributing to severe disease manifestations (Martinez-Lopez et al, 2010; Goeijenbier et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Leptospira Infection Interferes with the Prothrombinase Complex Assembly during Experimental Leptospirosis

Vieira

Andrade²,

Morais

et al. 2017

Front. Microbiol.

View full text Add to dashboard Cite

Leptospirosis is a worldwide zoonotic and neglected infectious disease of human and veterinary concern, caused by pathogenic Leptospira species. Although bleeding is a common symptom of severe leptospirosis, the cause of hemorrhage is not completely understood. In severe infections, modulation of hemostasis by pathogens is an important virulence mechanism, and hemostatic impairments such as coagulation/fibrinolysis dysfunction are frequently observed. Here, we analyze the coagulation status of experimentally infected hamsters in an attempt to determine coagulation interferences and the origin of leptospirosis hemorrhagic symptomatology. Hamsters were experimentally infected with L. interrogans. The lungs, kidneys, and livers were collected for culture, histopathology, and coagulation assays. L. interrogans infection disturbs normal coagulation in the organs of animals. Our results suggest the presence of a thrombin-like factor or FX activator, which is able to activate FII in the leptospirosis organ extracts. The activity of those factors is accelerated in the prothrombinase complex. Additionally, we show for the first time that live leptospires act as a surface for the prothrombinase complex assembly. Our results contribute to the understanding of leptospirosis pathophysiological mechanisms and may open new routes for the discovery of novel treatments in the severe manifestations of the disease.

show abstract

Evaluation of hemostasis disorders and anticardiolipin antibody in patients with severe leptospirosis

Cited by 24 publications

References 21 publications

Clinical presentation of leptospirosis: a retrospective study of 201 patients in a metropolitan city of Brazil

Clinical presentation of leptospirosis: a retrospective study of 201 patients in a metropolitan city of Brazil

Pancreatic involvement in fatal human leptospirosis: clinical and histopathological features

Leptospira Infection Interferes with the Prothrombinase Complex Assembly during Experimental Leptospirosis

Contact Info

Product

Resources

About