Schistosomiasis is a serious public health problem in some regions of the world. It is endemic in more than 74 countries and accounts for the majority of the cases of portal hypertension among the young population in these areas. Around the world, it is believed that there are about 200 million people infected by the Schistosoma species S. mansoni, S. haematobium, S. japonicum, S. intercalatum and S. mekongi 1,2 .The temporal clinical and systemic forms of the disease are: acute (toxemic and non-toxemic), latent and chronic 2,3 . The latter is divided into mild forms (intestinal and hepaticintestinal) and severe forms (hepatosplenic, pulmonary and glomerular) 2,3 .The presence and clinical significance of neurological lesions depend on the combination of the presence of eggs in the nervous system and the immune response of the host. In the majority of cases, a type IV or granulomatous delayed immune response occurs, and the response is greater in the earlier phases of schistosomiasis. In chronic forms, it becomes localized and attenuated (immunological modulation phenomenon) 4,5 .
ABSTRACTThe diagnosis of schistosomal myelitis (SM) is frequently presumptive because no findings from any complementary examination are pathognomonic for this disease. The present report describes some abnormalities seen on magnetic resonance imaging (MRI) evaluation of a series of SM patients and discusses their etiopathogenesis. Methods: This study evaluated SM patients at the time of their diagnosis. These patients routinely underwent MRI on all segments of the spinal cord. Results: Thirteen patients were evaluated. The MRI was abnormal in 12 (92.3%) of them. In 11 patients (84.61%), the damage reached two or more spinal segments. Conclusions: MRI was an important diagnostic aid in this sample, because of the high rate of abnormalities detected. The tissue damage observed on MRI was extensive in the majority of the patients.Key words: Schistosoma mansoni, neuroschistosomiasis, myelitis, magnetic resonance imaging, diagnosis.
RESUMOO diagnóstico da mielite esquistossomótica é frequentemente realizado por presunção, não havendo achado de exame complementar que seja patognomônico à condição. O presente estudo descreve alterações presentes na avaliação desses pacientes pela técnica da ressonân-cia magnética e discute sua etiopatogênese. Métodos: O estudo avaliou pacientes com mielite esquistossomótica no momento do diagnós-tico, os quais foram submetidos, rotineiramente, à ressonância magnética de todos os segmentos medulares. Resultados: Foram avaliados 13 pacientes, sendo a ressonância magnética alterada em 92.3% dos casos. Em 11 pacientes (84.61%), o dano abrangeu dois ou mais segmentos espinais. Conclusões: A ressonância magnética espinhal foi um importante auxílio diagnóstico nessa casuística em virtude da alta taxa de alterações detectadas. O dano tecidual observado foi extenso na maioria dos pacientes.Palavras-Chave: Schistosoma mansoni, neuroesquistossomose, mielite, imagem por ressonância magnética, diagnóstico.