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Jornal Português de Gastrenterologia

versão impressa ISSN 0872-8178

J Port Gastrenterol. v.13 n.2 Lisboa mar. 2006

 

Liver disease due to schistosoma guineensis - a review*

A. Murinello1, N. Germano1, P. Mendonça 1, C. Campos 1, A. Grácio2

 

Resumo

Baseados no caso de uma doente natural da ilha de São Tomé, com doença intestinal e hipertensão portal por doença hepática em resultado de infecção por Schistosoma guineensis, os autores fazem uma revisão concisa deste tipo de schistosomíase, incluindo o ciclo de vida do parasita, diagnóstico da infecção, anatomia patológica, imunopatogénese, quadro clínico, complicações da doença e terapêutica. A distribuição geográfica do Schistosoma guineensis está restringida de uma forma geral à África Central Ocidental, na região do Golfo da Guiné, e é a única espécie de Schistosoma presente na ilha de São Tomé. Habitualmente considerada uma doença relativamente ligeira da parte terminal do cólon, muitas vezes assintomática, outras vezes manifestada por disenteria schistosómica, os autores referem além do propósito, quatro casos de infecções em naturais da mesma ilha, que apresentaram problemas graves, dois com envolvimento do sistema nervoso central, um com doença hepática e envolvimento cardiopulmonar, e o caso de um adolescente com doença hepática e atraso de crescimento devido a níveis baixos de factores de crescimento insulínico 1 e 2 (IGF1 e IGF2) (antigamente chamadas somatomedinas). É importante ter conhecimento destas possibilidades evolutivas, de forma a que a terapêutica possa ser feita em tempo útil e assim se obter um bom resultado terapêutico.

 

Summary

Based on the case of a patient from the island of São Tomé who presented with intestinal and liver disease with portal hypertension due to infection with Schistosoma guineensis, the authors provide a concise review of this type of schistosomiasis, including the parasite life cycle, diagnosis, pathology, immunopathogenesis and the clinical picture of the infection, as well as posible complications and treatment. Schistosoma guineensis is geographically restricted to Central Western Africa and is the only Schistosoma species on the island of São Tomé. Usually considered to be a relatively minor disease of the lower bowel, the authors refer to four other cases on the same island that presented with serious problems, two with central system nervous disorders, one with a liver disorder and cardiopulmonary involvement, and one with liver disease and failure to thrive due to low levels of insulin growth factors IGF1 and IGF2 (formerly called somatomedins). It is important to be aware of the symptoms that may be found, so therapy can be given in time to obtain a good outcome.

 

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* The Clinical Report was presented as Posters in: a) Scientific Meeting on "Medicine and Health in the Tropics", in Marseille, France, 11-15 Set. 05, during the "XVIth International Congress for Tropical Medicine and Malaria, IVth European Congress on Tropical Medicine and International Health, VIIe Congrès International de la Societé de Pathologie Exotique", and on the date of the "Centenaire de L' Institute de Médecine Tropicale du Service de anté des Armés (L'Ècole du Pharo)"; b) "5as Jornadas de Actualização em Doenças Infecciosas", of the Hospital Curry Cabral, in Lisbon, Portugal, winning the first prize "ex-equo" for Poster presentations.

(1) Hospital de Curry Cabral, Divisions of Internal Medicine 1 and Pathology, Lisboa, Portugal.

(2) Instituto de Higiene e Medicina Tropical, Helmintology Department Lisboa. Portugal.

 

Recebido para publicação: 26/09/2005

Aceite para publicação: 15/02/2006