Hepatic parenchymal dysfunction in Schistosoma japonicum infection.
Decompensated liver disease was investigated in 94 unselected Filipino patients sequentially hospitalized with Schistosoma japonicum infection. Liver damage was objectively scored from 3 (none) to a maximum of 10 (severe damage with encephalopathy) using a modified Pugh-Child grading system. Liver parenchymal dysfunction occurred in 52% of patients and was severe in 21% (hepatic encephalopathy or markedly prolonged prothrombin time). Severity scores were higher in patients with previous gastrointestinal bleeding (7.3 vs. 5.1; P less than .001) and were inversely correlated with admission hematocrit (r = -.60; P less than .001). Ultrastructural analysis revealed abnormalities of Disse's space--the site of blood-hepatocyte exchange. Praziquantel achieved 100% parasitologic cure, but none of the 27 patients followed up for a mean of 9.6 months after receiving it had resolution of liver damage. Liver parenchymal dysfunction is a common problem in hospitalized schistosomiasis patients and persists after parasitologic cure.
Watt
G
G
United States Naval Medical Research Unit Number, Manila, Philippines.
Padre
L P
LP
Tuazon
M
M
Wotherspoon
A
A
Adapon
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000983:Antipyrine / Q000627:therapeutic use; D001707:Biopsy, Needle; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green; D008099:Liver / Q000473:pathology / Q000503:physiopathology* / Q000648:ultrastructure; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D011223:Praziquantel / Q000627:therapeutic use; D012554:Schistosomiasis japonica / Q000188:drug therapy / Q000503:physiopathology*; D016896:Treatment Outcome
D011223:Praziquantel; D007208:Indocyanine Green; D000983:Antipyrine