Correlation between the values of circulating blood elements with the size of spleen in the presence of schistosomal splenomegaly

Chronic murine schistosomiasis causes aberrant hemostasis

Schistosomiasis afflicts >250 million people worldwide, leading to an annual loss of >3 million disability-adjusted life years. Schistosoma mansoni causes intestinal schistosomiasis with parasite eggs either transversing intestinal tissue or lodging within the liver and other organs, causing intestinal hemorrhage and liver pathology. Large (∼1 cm) adult worms survive for years within blood vessels, but we lack a clear understanding of their impact on hemostasis. We used a chronic mouse model of schistosomiasis to determine the impact on platelet numbers, phenotype and function. Hemostatic function was assessed by platelet phenotyping (flow cytometry and proteomics), whole blood aggregometry, and longitudinal coagulometry. Although platelets from schistosome-infected mice lack elevated surface P-selectin and activated αIIbβ3, unbiased proteomic analysis reveals infection-induced increases in MHC-I, IgM and IgG antibodies, and complement components. Whole blood from schistosome-infected mice spontaneously aggregates in the absence of exogenous agonists. Conversely, prothrombin and activated partial thromboplastin times are prolonged at the chronic stage of infection (10-12 weeks). A mouse model of S. mansoni infection shows wide-ranging changes in hemostatic function which may have clinically relevant implications for populations in endemic regions.

Portal thrombosis after surgical treatment of schistosomatic portal hypertension

OBJECTIVE

Several studies have investigated the correlation between the effects of different surgical treatments and laboratory exams for schistosomal portal hypertension, especially concerning portal system thrombosis. The etiopathogenic factors of this thrombosis are not fully understood. In this study, the correlation between surgical treatment for schistosomal portal hypertension and the occurrence of postoperative portal system thrombosis was investigated.

METHODS

A total of 61 patients who underwent surgical treatment for schistosomal portal hypertension were distributed into four groups: Patients in Group 1 (n=12) underwent portal variceal disconnection associated with splenic artery ligation and spleen preservation. Patients in Group 2 (n=20) underwent portal variceal disconnection and total splenectomy. Patients in Group 3 (n=20) underwent portal variceal disconnection with subtotal splenectomy, preserving the upper splenic pole supplied by the splenogastric vessels. Patients in Group 4 (n=9) underwent portal variceal disconnection with total splenectomy and autogenous splenic implants on the greater omentum. Late postoperative portal vein thrombosis was diagnosed using Doppler ultrasound.

RESULTS

Over the 10-year follow-up, portal vein thrombosis occurred in 26 operated patients (42.6%), with no significant difference observed among the four surgical groups (p=0.217). Most of the thrombi only partially occluded the portal system veins. All the patients presented with a thrombus inside the portal vein. There was no difference in hematological and biochemical tests between groups with or without portal vein thrombosis.

CONCLUSIONS

Portal vein thrombosis is often observed in the late postoperative period, irrespective of the surgical treatment employed, and is not associated with patient characteristics or any hematological and biochemical tests.

A study on the correlation between spleen volume estimated via cavalieri principle on computed tomography images with basic hemogram and biochemical blood parameters

Considering its hematological and immunological functions, spleen is a very important organ. A change occurs in its size as the spleen performs these functions. This study aims to examine the possible relationships between spleen volume and the basic hemogram and biochemical parameters in serum. Multidetector computed tomography images and basic hemogram and biochemical parameters of 74 adult individuals, 34 male and 40 female, who were found to be healthy, were used in the study. Spleen volume was estimated using the Cavalieri method on multidetector computed tomography images and the correlations between the volume value with basic hemogram and biochemistry parameters were researched. While negative significant correlations were found between the estimated spleen volume and lymphocyte percentage (r=–0.224) and platelet level (r=–0.271); positive significant correlations were found between hemoglobin level (r=0.228), hematocrit level (r=0.237), alanine aminotransferase (r=0.345), and erythrocyte level (r=0.375). As a result of this study, a relationship was found between spleen volume and lymphocyte percentage, hematocrit level, erythrocyte level, platelet level, and alanine aminotransferase level in serum. We believe that the results of the study will provide a larger perspective to clinicians in the diagnosis of diseases associated with spleen.