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Sickle cell hepatopathy  [cached]
Bandyopadhyay Ranjana,Bandyopadhyay Sanjay,Dutta Anita
Indian Journal of Pathology and Microbiology , 2008,
Abstract: Sickle cell hepatopathy is a well-documented entity that ranges from the self-limiting hepatic right upper quadrant syndrome to the potentially lethal intrahepatic cholestasis and acute hepatic sequestration syndromes. We describe a 26-year-male with homozygous sickle cell disease who had this unique hepatic presentation and was documented to have characteristic findings of cholestasis, portal inflammation and sinusoidal dilatation on histopathology.
Angiogenesis and schistosomal granuloma formation
Baptista, Ana Paula;Andrade, Zilton A;
Memórias do Instituto Oswaldo Cruz , 2005, DOI: 10.1590/S0074-02762005000200012
Abstract: an increasing amount of evidences points to angiogenesis as playing a paramount role in fibrosis development. however, granulomas in general, and periovular schistosomal granulomas in particular, are considered avascular structures, although they usually result in dense areas of focal fibrosis. in order to clarify this apparent paradox, the presence of blood vessels was systematically searched in hepatic schistosomal granulomas of mice, during different stages of the infection, and at different stages of granuloma evolution, by means of vascular injections of colored masses, demonstration of laminin in vascular basement membranes and by ultra structural analysis. vascular proliferation appeared evident at the early stages of granuloma formation, gradually decreasing thereafter, older granulomas becoming almost avascular structures, sometimes delimited at the periphery by a rich vascular network.
Schistosomal glomerular disease (a review)
Andrade, Zilton A.;Van Marck, E.;
Memórias do Instituto Oswaldo Cruz , 1984, DOI: 10.1590/S0074-02761984000400017
Abstract: in this review paper schistosomal glomerulopathy is defined as an immune-complex disease. the disease appears in 12-15 per cent of the individuals with hepatosplenic schistosomiasis. portal hypertension with collateral circulation helps the by pass of the hepatic clearance process and the parasite antigens can bind to antibodies in the circulation and be trapped in the renal glomerulus. chronic membranousproliferative glomerulonephritis is the most commom lesion present and the nephrotic syndrome is the usual form of clinical presentation. the disease can be experimentally produced, and schistosomal antigens and antibodies, as well as complement, can be demonstrated in the glomerular lesions. specific treatment of schistosomiasis does not seem to alter the clinical course of schistosomal nephropathy.
Schistosomal peritonitis secondary to perforated appendicitis
Mazigo, Humphrey D;Giiti, Geofrey C;Zinga, Maria;Heukelbach, Jorg;Rambau, Peter;
Brazilian Journal of Infectious Diseases , 2010, DOI: 10.1590/S1413-86702010000600013
Abstract: in tanzania, schistosoma mansoni is endemic and causes intestinal schistosomiasis which affects various internal organs. however, worldwide there have been very few reports of cases of peritonitis due to schistosomal appendicitis. here we report a rare case of schistosomal appendicitis with peritonitis in a 33 year-old male patient who recovered quickly after surgery
Significance of schistosomal granuloma modulation
Silva, Luciana M;Fernandes, André LM;Barbosa Jr, Aryon;Oliveira, Irismar R;Andrade, Zilton A;
Memórias do Instituto Oswaldo Cruz , 2000, DOI: 10.1590/S0074-02762000000300010
Abstract: hepatic schistosoma mansoni periovular granulomas undergo changes in size, cellular composition and appearance with time. this phenomenom, known as "immunological modulation", has been thought to reflect host immunological status. however, as modulation has not been observed outside the liver, participation of local factors, hitherto little considered, seems crucial. components of the extracellular matrix of periovular granulomas of the mouse were particularly studied in three different organs (liver, lung and intestine) and during three periods of infection time (acute, intermediate and chronic) by means of histological, biochemical and imunofluorescence techniques, while quantitative data were evaluated by computerized morphometry, in order to investigate participation of local factors in granuloma modulation. results confirmed modulation as a exclusively hepatic phenomenom, since pulmonary and intestinal granulomas, formed around mature eggs, did not change size and appearance with time. the matricial components which were investigated (type i, iii and iv collagens, fibronectin, laminin, proteoglycans and elastin) were found in all granulomas and in all organs examined. however, their presence was much more prominent in the liver. elastin was only found in hepatic granulomas of chronic infection. the large amount of extracellular matrix components found in hepatic granulomas was the main change responsible for the morphological aspects of modulation. therefore, the peculiar environment of the liver ultimately determines the changes identified in schistosomal granuloma as "modulation".
Significance of schistosomal granuloma modulation  [cached]
Silva Luciana M,Fernandes André LM,Barbosa Jr Aryon,Oliveira Irismar R
Memórias do Instituto Oswaldo Cruz , 2000,
Abstract: Hepatic Schistosoma mansoni periovular granulomas undergo changes in size, cellular composition and appearance with time. This phenomenom, known as "immunological modulation", has been thought to reflect host immunological status. However, as modulation has not been observed outside the liver, participation of local factors, hitherto little considered, seems crucial. Components of the extracellular matrix of periovular granulomas of the mouse were particularly studied in three different organs (liver, lung and intestine) and during three periods of infection time (acute, intermediate and chronic) by means of histological, biochemical and imunofluorescence techniques, while quantitative data were evaluated by computerized morphometry, in order to investigate participation of local factors in granuloma modulation. Results confirmed modulation as a exclusively hepatic phenomenom, since pulmonary and intestinal granulomas, formed around mature eggs, did not change size and appearance with time. The matricial components which were investigated (Type I, III and IV collagens, fibronectin, laminin, proteoglycans and elastin) were found in all granulomas and in all organs examined. However, their presence was much more prominent in the liver. Elastin was only found in hepatic granulomas of chronic infection. The large amount of extracellular matrix components found in hepatic granulomas was the main change responsible for the morphological aspects of modulation. Therefore, the peculiar environment of the liver ultimately determines the changes identified in schistosomal granuloma as "modulation".
Guidelines for the diagnosis and treatment of schistosomal myeloradiculopathy
Lambertucci, José Roberto;Silva, Luciana Cristina dos Santos;Amaral, Ronaldo Santos do;
Revista da Sociedade Brasileira de Medicina Tropical , 2007, DOI: 10.1590/S0037-86822007000500016
Abstract: schistosomal myeloradiculopathy is the most severe and disabling ectopic form of schistosoma mansoni infection. the prevalence of smr in centres in brazil and africa that specialise in attending patients with non traumatic myelopathy is around 5%. the initial signs and symptoms of the disease include lumbar and/or lower limb pain, paraparesis, urinary and intestinal dysfunctions, and impotence in men. the cerebrospinal fluid of smr patients shows an increase in protein concentration and in the number of mononuclear cells in 90% of cases; eosinophils have been reported in 40%. the use of magnetic resonance imaging is particularly valuable in the diagnosis of schistosomal myeloradiculopathy. the exclusion of other myelopathies and systemic diseases remains mandatory. early diagnosis and treatment with steroids and schistosomicides provide a cure for most patients, whilst delayed treatment can result in irreversible physical disabilities or death. to improve awareness concerning schistosomal myeloradiculopathy amongst public health professionals, and to facilitate the control of the disease, the brazilian ministry of health has launched a program of education and control of this ectopic form of schistosomiasis. the present paper reviews current methods for the diagnosis of smr and outlines protocols for treatment of the disease.
Myofibroblasts in Schistosomal Portal Fibrosis of Man
Andrade, Zilton A;Guerret, Sylviane;Fernandes, André LM;
Memórias do Instituto Oswaldo Cruz , 1999, DOI: 10.1590/S0074-02761999000100018
Abstract: myofibroblasts, cells with intermediate features between smooth muscle cells and fibroblasts, have been described as an important cellular component of schistosomal portal fibrosis. the origin, distribution and fate of myofibroblasts were investigated by means of light, fluorescent, immunoenzymatic and ultrastructural techniques in wedge liver biopsies from 68 patients with the hepatosplenic form of schistosomiasis. results demonstrated that the presence of myofibroblasts varied considerably from case to case and was always related to smooth muscle cell dispersion, which occurred around medium-sized damaged portal vein branches. by sequential observation of several cases, it was evident that myofibroblasts derived by differentiation of vascular smooth muscle and gradually tended to disappear, some of them further differentiating into fibroblasts. thus, in schistosomal pipestem fibrosis myofibroblasts appear as transient cells, focally accumulated around damaged portal vein branches, and do not seem to have by themselves any important participation in the pathogenesis of hepatosplenic schistosomiasis.
Myofibroblasts in Schistosomal Portal Fibrosis of Man  [cached]
Andrade Zilton A,Guerret Sylviane,Fernandes André LM
Memórias do Instituto Oswaldo Cruz , 1999,
Abstract: Myofibroblasts, cells with intermediate features between smooth muscle cells and fibroblasts, have been described as an important cellular component of schistosomal portal fibrosis. The origin, distribution and fate of myofibroblasts were investigated by means of light, fluorescent, immunoenzymatic and ultrastructural techniques in wedge liver biopsies from 68 patients with the hepatosplenic form of schistosomiasis. Results demonstrated that the presence of myofibroblasts varied considerably from case to case and was always related to smooth muscle cell dispersion, which occurred around medium-sized damaged portal vein branches. By sequential observation of several cases, it was evident that myofibroblasts derived by differentiation of vascular smooth muscle and gradually tended to disappear, some of them further differentiating into fibroblasts. Thus, in schistosomal pipestem fibrosis myofibroblasts appear as transient cells, focally accumulated around damaged portal vein branches, and do not seem to have by themselves any important participation in the pathogenesis of hepatosplenic schistosomiasis.
Action of colchicine on hepatic schistosomal granuloma
Andrade, Zilton A.;Medeiros, Maria Vilma M. P.;Azevedo, Theomira M.;Guerret, Sylviane;
Memórias do Instituto Oswaldo Cruz , 1990, DOI: 10.1590/S0074-02761990000100013
Abstract: amorphous material and altered collagen fragments within dilated secretory vesicles and cisternae of fibroblast cytoplasm were the main ultrastructural changes seen in hepatic periovular granulomas formed in mice infected with schistosoma mansoni and treated with colchicine. despite promoting ultrastructural changes in the fibroblasts found in hepatic periovular granulomas, colchicine administration to infected mice did not significantly change the light microscopic appearance of the hepatic schistosomal lesions, did not diminish the amount of total hepatic collagen, and did not change the collagen isotypes in the granulomas, as observed after a comparative study with non-colchicine treated infected control mice. when administered to mice two weeks after curative treatment of schistosomiasis with praziquantel, colchicine did not seem to increase extracellular collagen degradation or to induce a more rapid resorption of hepatic periovular granulomas, although still promoting ultrastructura alterations in fibroblasts.
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