title: Anicteric cholangiopathy in schistosomiasis patients.
abstract: We previously reported that in anicteric patients with the isolated form of schistosomiasis (without co-morbidities) an ursodeoxycholic acid-sensitive increase in serum gamma-glutamyltransferase activity (gammaGT) occurs. We now describe the presence of cholangiopathy in these patients.
  
  
  METHODS
  Sixteen adult anicteric patients with the isolated form of schistosomiasis mansoni were carefully selected: nine with increased gammaGT and seven with normal gammaGT. High sensitive C-reactive protein (CRP), to exclude inflammatory status, hyaluronic acid (HA), and other laboratory parameters were determined. The ultrasonographic study measured spleen length, portal vein and splenic vein diameters, and the portal flow. Magnetic resonance cholangiopancreatography (MRCP) images were interpreted by a blind observer. MRCP was deemed abnormal when focal narrowing and/or paucity of second and third order biliary branches and/or irregularities in the contours of biliary pathways were identified.
  
  
  RESULTS
  Both groups (normal and elevated gammaGT) have preserved hepatic function tests (HA, serum albumin, prothrombin time) and clinical significant portal hypertension (low platelet count and ultrasonographic parameters). MRCP was abnormal in all patients with elevated gammaGT but in only 3 of the 7 patients with normal gammaGT (p=0.003).
  
  
  CONCLUSIONS
  Magnetic resonance cholangiopancreatography characterized a cholangiopatic disorder in anicteric patients with the isolated form of schistosomiasis, even preceding laboratory test alterations.
authors.affiliation: Department of Medicine, Universidade Federal de São Paulo, Rua Jabuticabeiras 807, 05674-011 São Paulo, Brazil.
authors.forename: Paulo Eugenio
authors.initials: PE
authors.lastname: Brant
authors.forename: Luciane
authors.initials: L
authors.lastname: Kopke-Aguiar
authors.forename: David Carlos
authors.initials: DC
authors.lastname: Shigueoka
authors.forename: Danilo
authors.initials: D
authors.lastname: Sales
authors.forename: Giuseppe
authors.initials: G
authors.lastname: D'Ippolito
authors.forename: Maria
authors.initials: M
authors.lastname: Kouyoumdjian
authors.forename: Durval R
authors.initials: DR
authors.lastname: Borges
mesh_terms: D000328:Adult; D000818:Animals; D001649:Bile Duct Diseases / Q000469:parasitology*; D049448:Cholangiopancreatography, Magnetic Resonance; D005260:Female; D006801:Humans; D006975:Hypertension, Portal; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging; D012555:Schistosomiasis mansoni / Q000150:complications*; D013154:Spleen / Q000000981:diagnostic imaging; D013162:Splenic Vein / Q000000981:diagnostic imaging; D014463:Ultrasonography; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D005723:gamma-Glutamyltransferase