Schistosoma mansoni infection in a recently exposed community in Senegal: lack of correlation between liver morphology in ultrasound and connective tissue metabolites in serum

Abstract

SummaryFour hundred and seventy villagers of Ndombo, a village with recently established intensive transmission of Schistosoma mansoni in the Senegal River Basin, were enrolled in a study with the intention to assess hepatosplenic morbidity. All patients were examined parasitologically and by ultrasound. Hepatic fibrosis serum markers were determined in 153 adult patients (aminoterminal propeptide of procollagen type III, hyaluronan and laminin). By ultrasound, about 60% of the patients showed early stages of hepatic involvement, 3% of the patients unequivocally showed severe hepatosplenic pathology (grade 3 according to the Managil classification), whereas in another study performed in the same village 3 years earlier, no patients with severe hepatosplenic pathology had been found. No correlation between the aminoterminal propeptide of procollagen type III, hyaluronan or laminin and the ultrasound findings could be established. These hepatic fibrosis serum markers do not seem to be a sensitive method to detect early hepatic fibrosis in schistosomiasis.keywords schistosomiasis, Senegal, ultrasound, hepatic fibrosis, procollagen type III, hyaluronan, laminin correspondence Dr. Gerd-Dieter Burchard,

Serum hyaluronan and collagen IV as non-invasive markers of liver fibrosis in patients from an endemic area for schistosomiasis mansoni: a field-based study in Brazil

“…Ricard-Blum et al (1999) found a good correlation between HA and ultrasound scores of fibrosis in an endemic area for schisto- somiasis in Madagascar. Burchard et al (1998) found no correlation and suggested that the increase of serum HA levels was actually related to inflammatory activity or liver function alterations that are absent in schistosomiasis, rather than to fibrosis itself. Yet, WHO patterns for ultrasound in schistosomiasis (Niamey Working Group 2000) have not been employed in the investigation of non-invasive markers of fibrosis.…”

Schistosomiasis mansoni in low transmission areas: abdominal ultrasound

“…This classification does not take into consideration the age or height of the patients (Burchard et al 1998). It is possible that adjusting a body-height dependent reference value, as proposed by the Niamey Working Group (2000), the ultrasound specificity could be improved.…”

Ultrasound versus biological markers in the evaluation of periportal fibrosis in human Schistosoma mansoni

“…Other authors, while studying intestinal or hepatointestinal patients, did not observe any significant difference in the serum levels of PIIINP that correlated with the presence or intensity of infection (Kardorff et al 1999), egg-positive individuals (Tanabe et al 1989) or fibrosis scores (Kardorff et al 1997, Burchard et al 1998, Ricard-Blum et al 1999. -Kardorff et al (1997-Kardorff et al ( , 1999 demonstrated that the procollagen IV peptide did not correlate with the presence or intensity of schistosomiasis infection, but it was significantly correlated with liver fibrosis, splenomegaly, portal vein dilatation and the presence of portosystemic collaterals.…”

“…A reduction in serum HA level was also revealed following early treatment with praziquantel in patients with the intestinal form of the disease (Hassanein et al 1997). Burchard et al (1998), studying 153 patients in Senegal with schistosomotic hepatic fibrosis, found no changes in patient levels of HA, laminin or PIIINP. A possible reason underlying these results could be that 60% of patients showed early stages of hepatic involvement with US, while only 3% presented with HS disease.…”

“…Some field studies evaluating individuals with milder forms of schistosomiasis did not reveal a correlation between laminin and PPF fibrosis (Kardorff et al 1997, Burchard et al 1998, Ricard-Blum et al 1999 and the presence or intensity of infection (Kardorff et al 1999). However, Tanabe et al (1989) and Ricard-Blum et al (1999) noted that the mean value of serum laminin was significantly higher in egg-positive infected patients than in endemic controls.…”