Hypoprothrombinemia in the compensated form of hepatosplenic schistosomiasis: further studies

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dc.contributor.author Forones, Nora Manoukian [UNIFESP]
dc.contributor.author Borges, Durval Rosa [UNIFESP]
dc.date.accessioned 2015-06-14T13:24:18Z
dc.date.available 2015-06-14T13:24:18Z
dc.date.issued 1988-08-01
dc.identifier http://dx.doi.org/10.1590/S0036-46651988000400005
dc.identifier.citation FORONES, Nora Manoukian; BORGES, Durval Rosa. Hypoprothrombinemia in the compensated form of hepatosplenic schistosomiasis: further studies. Rev. Inst. Med. trop. S. Paulo, São Paulo , v. 30, n. 4, p. 274-280, ago. 1988
dc.identifier.issn 0036-4665
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/232
dc.description.abstract Coagulation abnormality is frequently observed in schistosomiasis patients but its pathophysiology has not been established. We measured, by immunodiffusion. the prothrombin-antigen concentration in 56 individuals; of these 19 with demonstrated compensated form of hepatosplenic schistosomiasis, 17 with cirrhosis and 20 were control subjects. Transaminases, albumin, transthyretin, prothrombin time, antithrombin III, factor VII, and fibrinogen were also evaluated. All parameters were altered in the cirrhotic group but only albumin, prothrombin and antithrombin III levels were altered in the schistosomiasis group. Ninety percent of the patients with cirrhosis and sixty percent of the patients with schistosomiasis had abnormal plasma levels of albumin, transthyretin, prothrombin-antigen, and/or antithrombin III; an impaired hepatic synthesis was responsible for these results. Conversely forty percent of the schistosomiasis patients with normal plasma concentrations of both albumin and transthyretin had decreased mean plasma levels of both prothrombin and antithrombin III. These results suggest that either proth rombin and antithrombin III are more sensitive markers of impaired hepatic synthesis in schistosomiasis than are levels of albumin and transthyretin combined, or a low grade chronic consumption of clotting proteins also occurs. Considering the latter hypothesis it is possible that the thrombin formed would be inhibited by antithrombin III with the complexed thrombin-antithrombin III being cleared by the liver. Consequently the plasma levels of both prothrombin and antithrombin would be decreased, but the level of fibrinogen would be preserved. en
dc.description.abstract Alterações na coagulação são frequentemente observadas em portadores da esquistossomose, mas sua fisiopatologia ainda não foi estabelecida. Medimos, por imunodifusão, a concentração da protrombina-antígeno em 56 indivíduos: 19 com a forma compensada da esquistossomose hepatoesplênica 17 com cirrose e 20 sadios. Foram também determinadas transaminases, albumina, transtiretina, tempo de protrombina, antitrombina III, fator VII e fibrinogênio. As médias de todos os parâmetros estavam alteradas no grupo cirrótico mas apenas as de albumina, protrombina e antitrombina III no grupo esquistossomótico. Noventa por cento dos portadores de cirrose e 60% dos portadores de esquistossomose tinham níveis plasmáticos diminuídos de albumina, transtiretina, protrombina e/ou antitrombina III; síntese hepática diminuída pode explicar estes resultados. Por outro lado, em 40% dos portadores de esqtiistossomose com concentrações plasmáticas de albumina e transtiretina normais as concentrações médias de protrombina e antitrombina III estavam diminuídas. Estes resultados sugerem que a protombina e antitrombina III são marcadores mais sensíveis de síntese hepática do que o conjunto albumina/transtiretina ou que um consumo crônico das proteínas da coagulação ocorra. Considerando esta última possibilidade é possível supor-se que a trombina formada seja inibida pela antitrombina III e o complexo trombina-antitrombina III depurado pelo fígado. Consequentemente os níveis plasmáticos de protrombina e antitrombina III diminuem mas o do fibrinogênio é preservado. pt
dc.format.extent 274-280
dc.language.iso eng
dc.publisher Instituto de Medicina Tropical
dc.relation.ispartof Revista do Instituto de Medicina Tropical de São Paulo
dc.rights Acesso aberto
dc.subject Prothrombin en
dc.subject Antithrombin III en
dc.subject Schistosomiasis en
dc.subject Coagulopathy en
dc.title Hypoprothrombinemia in the compensated form of hepatosplenic schistosomiasis: further studies en
dc.title.alternative Hipoprotrombinemia na forma-compensada da esquistossomose hepatoesplênica: novos estudos pt
dc.type Artigo
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.description.affiliation Escola Paulista de Medicina Department of Medicine Division of Gastroenterology
dc.description.affiliationUnifesp UNIFESP, EPM, Department of Medicine Division of Gastroenterology
dc.identifier.file S0036-46651988000400005.pdf
dc.identifier.scielo S0036-46651988000400005
dc.identifier.doi 10.1590/S0036-46651988000400005
dc.description.source SciELO
dc.identifier.wos WOS:A1988Q832000005



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