Correlação entre esplenomegalia e plaquetopenia na forma hepatoesplênica da esquistossomose mansônica

Abstract

HEADINGSHypertension, portal. Schistosomiasis mansoni. Blood platelets.ABSTRACT -Background -It is known that both leukopenia and thrombocytopenia were significantly correlated with splenomegaly, but there is no studies correlating directly or precisely the size of the spleen with the number of platelets. It is controversial whether the thrombocytopenia observed in patients with chronic liver disease is more related to splenomegaly or portal hypertension itself. Aim -To correlate the serum level of platelets in pre and postoperative weight and volume of the spleen in patients with hepatosplenic schistosomiasis with indication for surgical treatment of portal hypertension. ). There was a statistically significant correlation between the numbers and logarithmic value of platelets in both preoperative with weight (p<0.01) with the elliptical volume (p<0.05) spleen. The number of platelets in the immediate postoperative period was correlated inversely with the weight of the spleen removed (p=0.0297 ), the logarithm value of platelets is also correlated with weight. The model used did not predict the serum concentrations of platelets based on weight and spleen volume. Conclusion -The variations in serum levels of platelets in both pre and postoperative period in patients with hepatosplenic schistosomiasis were directly correlated to changes in weight and volume of the spleen. Splenomegaly was directly responsible for the variation in the number of platelets.RESUMO -Racional -Sabe-se que tanto a leucopenia quanto a plaquetopenia têm relação direta com a esplenomegalia, mas não existem estudos correlacionando de forma direta ou precisa o tamanho do baço com o número de plaquetas. Ainda há controvérsia se a plaquetopenia observada em pacientes com doenças hepáticas crônicas está mais relacionada à esplenomegalia ou à própria hipertensão portal. Objetivo -Correlacionar o nível sérico das plaquetas nos períodos pré e pós-operatório imediato com peso e volume do baço em pacientes portadores da forma hepatoesplênica da esquistossomose com indicação para tratamento cirúrgico da hipertensão portal. ). Observou-se correlação estatisticamente significante entre o número e valor logarítmico das plaquetas no período pré-operatório tanto com peso (p<0,01) quanto com o volume elíptico (p<0,05) do baço. O número de plaquetas no pós-operatório imediato esteve correlacionado de modo inverso com o peso do baço retirado (p=0,0297); o valor logaritmo das plaquetas também se correlacionou com o peso. Não se conseguiu, através do modelo empregado, prever o valor sérico das plaquetas baseando-se no peso e volume esplênicos. Conclusão -As variações do nível sérico de plaquetas tanto no pré como no pós-operatório, em pacientes portadores da forma hepatoesplênica da esquistossomose mansônica, apresentam-se diretamente correlacionadas às variações de peso e volume do baço. A esplenomegalia foi diretamente responsável pela variação do número de plaquetas.

Correlation between the values of circulating blood elements with the size of spleen in the presence of schistosomal splenomegaly

“…Among the cytopenias observed, plateletopenia was the most common, followed by leukopenia and anemia. These findings were also reported in other studies [24][25][26][27][28][29][30] .…”

“…Neither thrombocytopania, present in 95% of the patients evaluated, nor the intensity of anemia proved to be correlated to the size of the spleen. Such results contradict studies conducted by Martins et al 25 , who found a correlation between splenomegaly and plateletopenia. However, these authors evaluated neither the leukocyte nor the erythrocyte series.…”

Investigação De Pancitopenia Associada a Esplenomegalia: Um Relato De Caso

“…A congestão do sistema porta-hepático, associada à esplenomegalia faz com que as linhagens eritrocíticas, plaquetárias e leucocitárias fiquem acumuladas e sejam posteriormente degradadas, dando origem à pancitopenia (MARTINS, 2010). Esse achado também pode ser observado ao realizar os exames laboratoriais do paciente, que apresentava plaquetopenia, anemia e leucopenia.…”

Comment on: Relationship between splenomegaly and hematologic findings in patients with hepatosplenic schistosomiasis

“…Martins et al ( 11 ) revisited 141 medical records of patients with hepatosplenic schistosomiasis mansoni submitted to the surgical treatment of portal hypertension. The variations in the serum levels of platelets in both the pre- and postoperative periods of these patients were directly correlated to changes in weight and volume of the spleen.…”

“…Some studies reported results relevant to the understanding of the importance of the correlation between splenomegaly and thrombocytopenia in hepatosplenic schistosomiasis. Martins et al ( 11 ) , analyzing the serum level of platelets in respect to pre and postoperative weight, tried to correlate this with volume of the spleen in patients with hepatosplenic schistosomiasis with indication for the surgical treatment of portal hypertension. He found that the number of platelets in the immediate postoperative period was inversely correlated with the weight of the spleen removed.…”