O fígado nas leptospiroses

Abstract

O s a u to r e s c h a m a m a a te n ç ã o p a r a o a s p e c to e n d ê m ic o -e p iã ê m ic o d a in fe c ç ã o n a G u a n ab a ra e r e g iõ e s p r ó x im a s . A s s in a la m fa to s r e fe r e n t e s a g r a v id a d e d a in fe c ç ã o e a o p o u c o c o n h e c im e n to d a s fo r m a s a n ic té r ic a s . D ão ê n fa s e à s m a n ife s t a ç õ e s d ig e s tiv a s e a s s in a la m c im p o r tâ n c ia d e se i n c lu ir as le p to s p ir o se s n o d ia g n ó s tic o d ife r e n c ia l d e à b d o m e c ir ú r g ic o p r in c i p a lm e n te a q u e le s c o m ic te r íc ia . C o n s id e r a m c o m o s in a is d e p r o g n ó s tic o g r a v e a i n s u fic iê n c ia r e n a l a g u d a c o m a n ú r ia , e. p r e s e n ç a d e h e m o r r a g ia d ig e s tiv a , c o n v u ls õ e s e / o u c h o q u e . D a s e x te r io r iz a ç õ e s d ig e s tiv a s o c o m p r o m e tim e n to h e p á tic o e a ic te r íc ia sã o os i t e n s a n a li sa d o s n o tr a b a lh o . O m a te r ia l e s tu d a d o c o n s ta d e 42 c a so s a n a lis a d o s d o p o n t o d e v is t a f u n c i o n a l e h is to p ato lô g ic o s e n d o q u e o m a te r ia l d e a u tó p s ia f o i o b tid o d e a p e n a s 3 c a so s e o r e s ta n te , a tr a v é s d e p u n ç ã o -b io p s ia . O m a io r g r a u d e ic te r íc ia f o i a lc a n ç a d o n a 2* e 3 * s e m a n a s d e d o e n ç a e o p r e d o m ín io a b s o lu to é o d a fr a ç ã o d a b ilir r u b in a d ir e ta . E le v a ç õ e s e x p r e s s iv a s ã a fo s fa ta s e a lc a lin a e c o le s te r o l a o la d o d e h ip e r b ilir r u b in e m ia s s e v e ra s e m tô r n o d a 2* e 3* s e m a n a d e d o e n ç a , c o n fig u r a r a m e m m u i t o s c a so s u m c o m p o n e n te o b str u t i v o im p o r t a n t e c o m c o r r e s p o n d ê n c ia n o s a c h a d o s d e h is to p a to lo g ia . E m n e n h u m a ocasião as tr a n s a m in a s e s u ltr a p a s s a r a m a 250 u K a r m e n a s s im c o m o n e c r o s e h e p á tio a e m n e n h u m e s p é c im e h is to p a to lô g ic o fo i im p o r t a n t e . 22 p a c ie n te s a p r e s e n ta r a m c ifr a s d e a tiv id a d e p r o tr o m b ín ic a in te r io r e s a 60% e os c a so s q u e r e c e b e r a m v i t a m i n a K l , r e s p o s ta s n ã o fo r a m o b tid a s . O s p r in c ip a is e le m e n to s d e e le tr o fo r e s e p r o té ic a e n c o n tr a d o s e m 26 p a c ie n te s fo r a m : h ip oa lb u m in e m ia e m to d o s , a lfa 2 e le v a d a s e m e x c e ç ã o , b e ta a c im a d e 0,90 g % e m 14 e g a m a s u p e r io r a 1,4 e m 15. A s p r o v a s d e flo c u la ç ã o e tu r v a ç ã o se m o s tr a r a m b a s ta n te a lte r a d a s e m 14. O s p r in c ip a is e le m e n to s d e p a to lo g ia e n c o n tr a d o s fo r a m lo c a liz a ç ã o c e n tr o lo b u la r d a lesão, d is so c ia ç ã o tr a b e c u la r , c o le s ta s e % d e g e n e r a ç ã o e r e g e n e ra ç ã o h e p a to c itá r ia s e p r o life r a ç ã o k u p f f er ia n a . E s ta s le...

Influence of breed on the clinical and hemato-biochemical parameters in sheep experimentally infected with Leptospira sp.

“…The decrease of the total protein, as well as the increase of the Gamma-glutamyl transpeptidase (GGT), mainly in the Santa Inês sheep, suggests a possible hepatic damage in the affected sheep (Stockham and Scott, 2011). Despite having increased, the aspartate aminotransferase, (AST) remained within the normal limits for the species (20–52 U/L), however it is important to highlight that the increase of the transaminases in the majority of cases is discreet in the leptospirosis (Gonçalves et al., 1971). Even though the sheep in this experiment did not present hepatic lesions in the histopathological evaluation, which carried out at the end of the experiment (Costa et al., 2018), this absence can be explained as the histological lesions in the liver are generally found in patients with a clinical history of more than 30 days (Gonçalves et al., 1971).…”