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Chronic Hepatic Schistosomiasis
Schistosomiasis Chronic Hepatic

Presentation

Material And Methods We present a review of 32 cases of Chronic schistosomiasis presenting over a span of 4 years (2001 to 2005) at King Faisal Hospital, Taif, Kingdom of Saudi Arabia. [ispub.com]

Nuclear and mild cytoplasmic immunoreactivity for HBcAg was present in some hepatocytes. [uscapknowledgehub.org]

Clinical Management Schistosomiasis has a broad spectrum of clinical presentations, and up to 10% of patients may have severe hepatosplenic presentation. [onlinelibrary.wiley.com]

Chronic Schistosomiasis may present in a wide variety of forms: Urinary schistosomiasis usually caused by S. haematobium – painful urination (dysuria), and blood in urine (hematuria). [web.stanford.edu]

Usually, these patients will present with portal hypertension signs and symptoms, including splenomegaly, gastroesophageal varices, hematemesis, and ascites. Hepatic function is commonly preserved until late stages 2. [radiopaedia.org]

Immune System

  • Splenomegaly

    Usually, these patients will present with portal hypertension signs and symptoms, including splenomegaly, gastroesophageal varices, hematemesis, and ascites. Hepatic function is commonly preserved until late stages 2. [radiopaedia.org]

    Periportal fibrotic bands and widened fissures Capsular calcification (parallel or perpendicular to liver surface) • Portal hypertension in advanced disease Splenomegaly and varices • US: Bull’s-eye lesion: Represents anechoic portal vein surrounded by [radiologykey.com]

    Imaging studies may reveal enlargement of the left liver lobe without changes in the liver parenchyma or splenomegaly. [onlinelibrary.wiley.com]

    The chronic consequences of Schistosoma mansonii infection include portal hypertension with splenomegaly, esophageal varices, and ascites. [coursera.org]

    On examination there was massive splenomegaly with minimal ascites. Magnetic resonance imaging revealed minimally shrunken liver with nodular regenerative hyperplasia. All autoimmune and viral markers were negative. [tropicalgastro.com]

Liver, Gall & Pancreas

  • Hepatosplenomegaly

    The relative risk to develop hepatosplenomegaly in persons infected with S. mansoni have been reported in correlation with HLA-A1 and B5[ 15 ]. [wjgnet.com]

    Hepatosplenomegaly and lymphadenopathy are usual. Chronic Schistosomiasis may present in a wide variety of forms: Urinary schistosomiasis usually caused by S. haematobium – painful urination (dysuria), and blood in urine (hematuria). [web.stanford.edu]

    Portal hypertension can develop and cause hepatosplenomegaly, ascites, and esophageal varices. [meddean.luc.edu]

    […] nervous system. schistosomiasis manso´ni infection with Schistosoma mansoni, living chiefly in the mesenteric veins but migrating to deposit eggs in venules, primarily of the large intestine; eggs lodging in the liver may lead to peripheral fibrosis, hepatosplenomegaly [medical-dictionary.thefreedictionary.com]

    The patients presented with hepatosplenomegaly and portal hypertension. Ultrasound examination showed hepatomegaly and portal fibrosis. [ispub.com]

Workup

X-Ray

  • Gastric Varices

    varices Pulmonary Venous Hypertension Schistosome eggs can be lodged in the lungs Dyspnea, cough, fatigue, swelling of lower extremities, pulmonary edema Can lead to cardiac failure No cure, only 50% patients clinically responsive to treatment Untreated [quizlet.com]

    varices – essentially, varicose veins in the esophagus and stomach, one of the most serious complications because they can rupture and bleed. [liversupport.com]

    Nonsurgical treatment of bleeding esophageal varices. The management of patients with esophageal and gastric varices remains challenging, particularly when prophylactic procedures are considered 82. [elsevier.es]

Biopsy

  • Hepatocellular Carcinoma

    carcinoma, particularly secondary to the S.Mansoni subtype Promoted articles (advertising) [radiopaedia.org]

    Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level. Jama 2006;295:65–73. CrossRef PubMed Google Scholar 23. Erhardt A, Göbel T, Ludwig A, et al. [link.springer.com]

    Transforming growth factor-alpha and epidermal growth factor receptor in chronic liver disease and hepatocellular carcinoma. Liver 1999;19: 318-325. 39- Oliveira SDS, Silva RC, Silva CLM. [pacificejournals.com]

    carcinoma liver failure – scar tissue can impair the functioning of normal liver tissuebleeding from blood vessels in the oesophagus or upper stomach (oesophageal varices) increased blood pressure in veins that take blood to the liver (portal hypertension [betterhealth.vic.gov.au]

    carcinoma) and (hepatoma) – risk varies with the cause of liver disease Enlarged spleen (Splenomegaly) Esophageal and gastric varices – essentially, varicose veins in the esophagus and stomach, one of the most serious complications because they can rupture [liversupport.com]

Treatment

Each chapter extensively reviews epidemiology, etiopathogenesis, clinical features, diagnosis, medical treatment, and surgical treatment. [books.google.com]

Estimates show that at least 220.8 million people required preventive treatment in 2017. Preventive treatment, which should be repeated over a number of years, will reduce and prevent morbidity. [who.int]

Treatment is curative in ~ 85% [9, 10]. Treatment is not necessarily effective in treating late stage complications such as oesophageal varices or cor pulmonale. [rch.org.au]

Treatment of liver cirrhosis Cirrhosis of the liver is incurable but, in some cases, treatment can help to reduce the likelihood that the condition will become worse. [betterhealth.vic.gov.au]

The drug, which is donated by Merck KGaA, is a fast, safe, and effective treatment for the disease. Treatment, paired with education about water, sanitation, and hygiene (WASH) is essential for prevention. [end.org]

Prognosis

[…] normal-appearing liver • US elastography demonstrates hepatic fibrosis • MR shows same morphologic signs as CT of liver damage and portal hypertension MR elastography provides a measure of extent of hepatic fibrosis, which may determine therapy and prognosis [radiologykey.com]

Outlook (Prognosis) Treatment before significant damage or severe complications occur usually produces good results. [ufhealth.org]

Prognosis If treated early, prognosis is very good and complete recovery is expected. The illness is treatable, but people can die from the effects of untreated schistomiasis. [encyclopedia.com]

What is the prognosis (outcome) for schistosomiasis? Early antiparasitic treatment, especially with acute schistosomiasis, may allow people to recover completely without developing chronic disease. [medicinenet.com]

Etiology

• Cirrhosis often has widened fissures but not as much periportal edema and fibrosis as with schistosomiasis PATHOLOGY General Features • Etiology S. japonicum : North Asia Only gold members can continue reading. Log In or Register to continue [radiologykey.com]

Etiology: The trematodes (flukes). Schistosomes are flukes that inhabit the portal vascular system. All species have similar life cycles. [meddean.luc.edu]

[…] elicit a host immune response Egg derived antigens induce a host Th2 immune response, leading to recruitment of eosinophils, granulomatous reaction and later fibrosis ( Immunol Rev 2004;201:156, Immunol Cell Biol 2007;85:148, Front Immunol 2013;4:89 ) Etiology [pathologyoutlines.com]

Recently, similar inclusions have been shown to occur in individuals without chronic HBV infection or any of the above mentioned well known etiologies. [uscapknowledgehub.org]

The etiology and pathogenesis of the endemic form of hepatosplenomegaly, “Egyptian splenomegaly”. J Egypt Med Assoc. 1947;30-48. 18. Symmers WSTC. Note on a new form of liver cirrhosis due to the presence of ova of Bilharzia haematobium. [wjgnet.com]

Epidemiology

Each chapter extensively reviews epidemiology, etiopathogenesis, clinical features, diagnosis, medical treatment, and surgical treatment. [books.google.com]

The epidemiology of hepatitis C in Egypt: a systemic review and data synthesis. Infect Dis 2013; 24(13):288-309. 3- Ibrahim M, Gomaa W, Ibrahim Y, El Hadad H, Shatat M, Abdel Aleem A, et al. [pacificejournals.com]

Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine. 2012;30(12):2212-9. Sozzi V, Walsh R, Littlejohn M, Colledge D, Jackson K, Warner N, et al. [sapd.es]

Image Credit: Jubal Harshaw / Shutterstock.com Epidemiology Schistosomiasis is the third most prevalent parasitic disease and has the second-largest impact on humans as compared to all other tropical diseases, after malaria. [news-medical.net]

The epidemiology of Schistosoma mansoni, hepatitis B and hepatitis C infection in Egypt. Ann Trop Med Parasitol 1994;88:501–509. PubMed Google Scholar 19. Angelico M, Renganathan E, Gandin C, et al. [link.springer.com]

Pathophysiology

Learn > Health > Basic Science > Tropical Parasitology: Protozoans, Worms, Vectors and Human Diseases course > Schistosomiasis: Pathophysiology - Dr. [coursera.org]

Abstract Hepatosplenic schistosomiasis, a widespread disease syndrome in large areas of the tropics, is a relatively unique clinical and pathophysiological entity. [annals.org]

Pathophysiology Infection with parasitic worms of the genus Schistosoma is responsible for causing schistosomiasis. [news-medical.net]

Africa, South America, Middle East S. japonicum : Southeast Asia S. haematobium : Africa, Middle Eastern Sites Liver, intestine, bladder, lungs, spleen, brain or spinal cord; less common sites of embolization include the skin and peritoneal surfaces Pathophysiology [pathologyoutlines.com]

Pathophysiology of portal hypertension and esophageal varices. International J Hepatol2012;Article ID 895787,7 pages. 22- Chang CC, Huang HC, Wang SS, Lee FY, Chang FY, Lin HC, et al. [pacificejournals.com]

Prevention

Prevention Unclean water sources play an essential role in the life cycle of the parasitic worms and must be addressed to improve methods of prevention. [news-medical.net]

Estimates show that at least 220.8 million people required preventive treatment in 2017. Preventive treatment, which should be repeated over a number of years, will reduce and prevent morbidity. [who.int]

Prevention Prevention of the disease involves several targets and requires long term community commitment. Infected patients require diagnosis, treatment, and education about how to avoid reinfecting themselves and others. [medical-dictionary.thefreedictionary.com]

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