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  • Severe hepatosplenic schistosomiasis: clinicopathologic study of 102 cases undergoing splenectomy

    Author(s)
    Li, Yuesheng
    Chen, Dongliang
    Ross, Allen G
    Burke, Melissa L
    Yu, Xinling
    Li, Robert S
    Zhou, Jie
    McManus, Donald P
    Griffith University Author(s)
    Burke, Melissa L.
    McManus, Don P.
    Li, Yuesheng
    Ross, Allen G.
    Year published
    2011
    Metadata
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    Abstract
    We present the preoperative findings of 102 patients who underwent successful splenectomy for advanced schistosomiasis japonica. All patients were symptomatic for schistosomiasis and had splenomegaly greater than or equal to II according to the Hackett criteria. Before surgery, all patients underwent clinical examination including full blood count; fibrinogen and serum protein levels; liver function tests; and serology for hepatitis B, C, and D. Ultrasound examination of the liver and spleen and liver histology for evidence of pathology were also undertaken. Ninety patients had a treatment history for schistosomiasis. Fifty-six ...
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    We present the preoperative findings of 102 patients who underwent successful splenectomy for advanced schistosomiasis japonica. All patients were symptomatic for schistosomiasis and had splenomegaly greater than or equal to II according to the Hackett criteria. Before surgery, all patients underwent clinical examination including full blood count; fibrinogen and serum protein levels; liver function tests; and serology for hepatitis B, C, and D. Ultrasound examination of the liver and spleen and liver histology for evidence of pathology were also undertaken. Ninety patients had a treatment history for schistosomiasis. Fifty-six patients were seropositive for hepatitis B virus antibody, and 6 patients were seropositive for hepatitis C virus antibody. Immunohistochemical testing of the liver samples confirmed that 45 patients were positive for hepatitis B virus surface antigen, thereby indicating active infection. A total of 66.7% of patients had fibrosis stages II to III by ultrasound; and 76.5% of patients had portal vein inner diameter greater than 12 mm, indicating portal vein hypertension. A total of 83.2% of patients showed various stages of esophageal varicosis via x-ray, and 81.4% had fibrotic stages III to IV by liver biopsy. Coinfection with hepatitis B virus accelerated the development of liver fibrosis. There was moderate concordance between the fibrosis assessed by ultrasonography and histopathology, indicating that ultrasound underestimates the true pathology. Combined assessment is needed to improve the diagnosis of clinical hepatic fibrosis.
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    Journal Title
    Human Pathology
    Volume
    42
    Issue
    1
    DOI
    https://doi.org/10.1016/j.humpath.2010.05.020
    Subject
    Medical Parasitology
    Clinical Sciences
    Publication URI
    http://hdl.handle.net/10072/39681
    Collection
    • Journal articles

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