Diagnosis and clinical management of hepatosplenic schistosomiasis: A scoping review of the literature

Tamarozzi, Francesca; Fittipaldo, Veronica Andrea; Orth, Hans Martin; Richter, Joachim; Buonfrate, Dora; Riccardi, Niccolò; Gobbi, Federico

doi:10.1371/journal.pntd.0009191

Cited by 28 publications

(19 citation statements)

References 98 publications

(136 reference statements)

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“…Hepatosplenic schistosomiasis is a heterogeneous condition, ranging from a mildly symptomatic to life-threatening disease [ 45 ] ( Figure 4 ). The most common presentation of hepatosplenic schistosomiasis was upper gastrointestinal bleeding leading to severe anemia [ 46 ].…”

Section: Hepatosplenic Schistosomiasismentioning

confidence: 99%

“…The most common presentation of hepatosplenic schistosomiasis was upper gastrointestinal bleeding leading to severe anemia [ 46 ]. In contrast to cirrhosis, in hepatosplenic schistosomiasis, hepatic function is preserved overall [ 45 ]. Several studies have demonstrated a correlation between disease severity (measured by i.e., organomegaly) and quantitative fecal egg output [ 47 ].…”

Section: Hepatosplenic Schistosomiasismentioning

confidence: 99%

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Clinical Spectrum of Schistosomiasis: An Update

Carbonell

Rodríguez‐Alonso

López-Bernús

et al. 2021

JCM

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Schistosomiasis is a helminthic infection and one of the neglected tropical diseases (NTDs). It is caused by blood flukes of the genus Schistosoma. It is an important public health problem, particularly in poverty-stricken areas, especially those within the tropics and subtropics. It is estimated that at least 236 million people worldwide are infected, 90% of them in sub-Saharan Africa, and that this disease causes approximately 300,000 deaths annually. The clinical manifestations are varied and affect practically all organs. There are substantial differences in the clinical presentation, depending on the phase and clinical form of schistosomiasis in which it occurs. Schistosomiasis can remain undiagnosed for a long period of time, with secondary clinical lesion. Here, we review the clinical profile of schistosomiasis. This information may aid in the development of more efficacious treatments and improved disease prognosis.

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Section: Hepatosplenic Schistosomiasismentioning

confidence: 99%

Section: Hepatosplenic Schistosomiasismentioning

confidence: 99%

Clinical Spectrum of Schistosomiasis: An Update

Carbonell

Rodríguez‐Alonso

López-Bernús

et al. 2021

JCM

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“…v) Splenic schistosomiasis, which may present as calcification, may occur following a history of contact with contaminated water. Further, it may present with symptoms such as anemia, leukopenia, thrombocytopenia, or hypersplenism ( 26 ). vi) Splenic hamartoma, which is rare and largely without obvious symptoms, may have cystic degeneration, calcification, and fat components.…”

Section: Discussionmentioning

confidence: 99%

A Primary Extraskeletal Osteosarcoma of the Spleen: Rare Case Report

Pan

Wang

Lin³

et al. 2022

Front. Oncol.

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Extraskeletal osteosarcoma is a rare malignant soft-tissue sarcoma that is difficult to diagnose. Surgery is a common treatment, although chemotherapy and radiotherapy are also used. Patients at risk of bleeding can undergo embolization combined with resection. The occurrence of primary splenic extraskeletal osteosarcoma in humans does not seem to have been reported in the literature. A 50-year-old woman who complained of pain in the left upper abdomen for 1 day was initially diagnosed with “splenic hemangioma with a high possibility of rupture and bleeding” and urgently underwent digital subtraction angiography, combined with splenic arteriography and embolization. Abdominal pain worsened 2 days postoperatively, with a hemoglobin level of 106.0 g/L. Consequently, emergency laparotomy combined with splenectomy was performed. The clinical and imaging features, pathological diagnosis, and embolization treatment of this case were analyzed retrospectively. CT of the upper abdomen revealed splenomegaly, an irregular low-density shadow in the spleen, and a flake-like calcification in the lateral margin of the left kidney. Nuclear MRI of the upper abdomen showed splenomegaly and a mass (approximately 8.4 cm × 5.7 cm × 6.3 cm) below the spleen with clear boundaries—this exhibited an uneven signal, which was slightly low in T1-weighted imaging (T1WI) and slightly high in T2-weighted imaging (T2WI). Several small cystic lesions or cystic cavities were observed in the mass, which exhibited a longer T2 signal. During the enhanced scan, the signal of the lesion showed progressive enhancement, and the enhancement range increased in the delayed phase scan, as well as a hematoma below the spleen capsule and calcification below the lesion (nodular T1WI/T2WI hypointense, approximately 3.3 cm × 3.6 cm). Postoperative biopsy pathology showed splenic soft tissue tumor: at low magnification, the multinucleated giant cells were scattered; at medium magnification, osteoclast-like multinucleated giant cells were observed; and at high magnification, lace- or grid-like tumor osteogenesis was detected. Immunohistochemistry showed that the expression of CD31, CD34, F8, s-100, desmin, SMA, and CD99 was negative, whereas the expression of β-catenin, BCL-2, SATB-2, and P16 was positive. CD68 and MDM-2 showed low expression, while 50% of the cells were positive for Ki-67 expression. No abnormal concentration of radioactivity was found on the bone scan with 99mTc-MDP after the operation, further ruling out the occurrence of other bone tumors. The patient was diagnosed with primary extraskeletal osteosarcoma. It is necessary for multidisciplinary teams to diagnose malignant extraskeletal osteosarcomas.

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“…Currently, surgical procedures are the best researched and most favored definitive therapy for HSS despite their high-grade invasiveness, perioperative mortality and the consequences of post-splenectomy syndrome. [14,15].…”

Section: Introductionmentioning

confidence: 99%

TIPS and splenorenal shunt for complications of portal hypertension in chronic hepatosplenic schistosomiasis–A case series and review of the literature

et al. 2021

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Background Transjugular intrahepatic portosystemic shunt (TIPS) and shunt surgery are established treatment options for portal hypertension, but have not been systematically evaluated in patients with portal hypertension due to hepatosplenic schistosomiasis (HSS), one of the neglected tropical diseases with major impact on morbidity and mortality in endemic areas. Methods In this retrospective case study, patients with chronic portal hypertension due to schistosomiasis treated with those therapeutic approaches in four tertiary referral hospitals in Germany and Italy between 2012 and 2020 were included. We have summarized pre-interventional clinical data, indication, technical aspects of the interventions and clinical outcome. Findings Overall, 13 patients with confirmed HSS were included. 11 patients received TIPS for primary or secondary prophylaxis of variceal bleeding due to advanced portal hypertension and failure of conservative management. In two patients with contraindications for TIPS or technically unsuccessful TIPS procedure, proximal splenorenal shunt surgery in combination with splenectomy was conducted. During follow-up (mean follow-up 23 months, cumulative follow-up time 31 patient years) no bleeding events were documented. In five patients, moderate and transient episodes of overt hepatic encephalopathy were observed. In one patient each, liver failure, portal vein thrombosis and catheter associated sepsis occurred after TIPS insertion. All complications were well manageable and had favorable outcomes. Conclusions TIPS implantation and shunt surgery are safe and effective treatment options for patients with advanced HSS and sequelae of portal hypertension in experienced centers, but require careful patient selection.

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Diagnosis and clinical management of hepatosplenic schistosomiasis: A scoping review of the literature

Cited by 28 publications

References 98 publications

Clinical Spectrum of Schistosomiasis: An Update

Clinical Spectrum of Schistosomiasis: An Update

A Primary Extraskeletal Osteosarcoma of the Spleen: Rare Case Report

TIPS and splenorenal shunt for complications of portal hypertension in chronic hepatosplenic schistosomiasis–A case series and review of the literature

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