title: Relationship between splenomegaly and hematologic findings in patients with hepatosplenic schistosomiasis.
abstract: BACKGROUND
  Schistosomiasis is a tropical disease. Patients who develop hepatosplenic schistosomiasis have clinical findings including periportal fibrosis, portal hypertension, cytopenia, splenomegaly and gastrointestinal hemorrhage.
  
  
  OBJECTIVE
  The aim of this study was to analyze the hemostatic and hematologic findings of patients with schistosomiasis and correlate these to the size of the spleen.
  
  
  METHODS
  Fifty-five adults with hepatosplenic schistosomiasis and 30 healthy subjects were selected through a history of contact with contaminated water, physical examination and ultrasound characteristics such as periportal fibrosis and splenomegaly in the Gastroenterology Service of the Universidade Federal de Pernambuco. Blood samples were collected to determine liver function, blood counts, prothrombin (international normalized ratio), partial thromboplastin time and fibrinogen and D-Dimer levels using the Pentra 120 hematological analyzer (HORIBA/ABX), Density Plus (test photo-optical Trinity Biotech, Ireland) and COBAS analyzer 6000 (Roche). Furthermore, the longitudinal size of the spleen was measured by ultrasound (Acuson X analyzer 150, Siemens). The Student t-test, the Fisher test and Pearson's correlation were used to analyze the results with statistical significance being set for a p-value < 0.05.
  
  
  RESULTS
  The mean age was higher for the Study Group than for the Control Group (54 ± 13.9 vs. 38 ± 12.7 years). The average longitudinal diameter of the spleen was 16.9 cm (Range: 12.3-26.3 cm). Anemia is a common finding in patients with schistosomiasis (36.3%). The mean platelet and leukocyte counts of patients were lower than for the Control Group (p-value < 0.001). Moreover, the international normalized ratio (1.42 vs. 1.04), partial thromboplastin time (37.9 vs. 30.5 seconds) and D-Dimer concentration (393 vs. 86.5 ng/mL) were higher for the Study Group compared to the Control Group.
  
  
  CONCLUSIONS
  This study suggests that hematological and hemostatic abnormalities are associated with splenomegaly, hypersplenism and portal hypertension.
authors.affiliation: Universidade Federal de Pernambuco - UFPE, Recife, PE, Brazil.
authors.forename: Luiz Arthur Calheiros
authors.initials: LA
authors.lastname: Leite
authors.forename: Ana Lúcia Coutinho
authors.initials: AL
authors.lastname: Domingues
authors.forename: Edmundo Pessoa
authors.initials: EP
authors.lastname: Lopes
authors.forename: Rita de Cássia Dos Santos
authors.initials: Rde C
authors.lastname: Ferreira
authors.forename: Adenor de Almeida
authors.initials: Ade A
authors.lastname: Pimenta
authors.forename: Caíque Silveira Martins
authors.initials: CS
authors.lastname: da Fonseca
authors.forename: Bianka Santana
authors.initials: BS
authors.lastname: Dos Santos
authors.forename: Vera Lúcia de Menezes
authors.initials: VL
authors.lastname: Lima
keywords: Hypersplenism; Schistosomiasis; Schistosomiasis mansoni; Splenomegaly; Thrombocytopenia