scholarly journals Clinical and laboratory findings in patients with dengue associated with hepatopathy

2011 ◽  
Vol 44 (6) ◽  
pp. 674-677 ◽  
Author(s):  
Delso do Nascimento ◽  
Ana Rita Coimbra Motta de Castro ◽  
Íris Bucker Froes ◽  
Gláucia Bigaton ◽  
Éveny Cristine Luna de Oliveira ◽  
...  

INTRODUCTION: Hepatic disorders caused by dengue infection may progress to severe manifestations, including mortality and morbidity. Cytokines are involved in it, such as the migration inhibitory factor of macrophages (MIF), tumor necrosis factor (TNF), natural killer cells (NK), B lymphocytes, and macrophages. METHODS: This study was carried out from January to April 2007 at a public hospital from the Federal University of Mato Grosso do Sul, Campo Grande, Brazil. Sixty-eight patients were studied concerning hepatic alterations, with 56 reported having classic dengue, 6 with hemorrhagic dengue grade I, and 6 with hemorrhagic dengue grade II. RESULTS: Among the 56 with classic dengue, 83.3% had aspartate aminotransferase (AST) alterations, and 69.6% had altered alanine aminotransferase (ALT). For those with hemorrhagic dengue grade I, 100% had AST alterations, and 83.3% had altered ALT. All the patients with hemorrhagic dengue grade II had AST and ALT alterations. AST variations reached 22.0 and 907.0, with an average value of 164.6. For ALT, we found variations between 25.0 and 867.0, with an average value of 166.07. There had been statistical significance between dengue clinical shapes and hepatic function markers. CONCLUSIONS: We conclude that the infection was predominant in adults, females, and in those with low income and education. The liver enzymes were of larger amount in hemorrhagic dengue, but there was weak statistical evidence of the clinical manifestations and transaminases. Major signs and clinical symptoms were fever, headache, myalgia, arthralgia, weakness, severe pain behind the eyes, and rashes.

Rev Rene ◽  
2021 ◽  
Vol 22 ◽  
pp. e70836
Author(s):  
Laurindo Pereira de Souza ◽  
Rafael Ayres Romanholo ◽  
Cidia Vasconcellos

Objective: to analyze the association of survival to emergency care measures, clinical symptoms and biochemical markers used for paraquat intoxicated patients. Methods: retrospective cohort, guided by the Strengthening the Reporting of Observational Studies in Epidemiology tool. The data collection and analysis protocol were based on two phases: first, with the survey of the investigation forms of exogenous poisoning from the Secretariat of Epidemiological Surveillance; second, with the analysis of information in printed medical records. Results: of the 36 (100%) patients investigated, 19 (53.0%) survived; regarding the clinical manifestations, there was statistical significance for the respiratory system (p=0.003); regarding the biochemical variables, there was statistical significance for liver enzymes. The initial emergency measures 13(56.5%) of survivors received gastric lavage with activated charcoal. Conclusion: we observed a lack of efficacy of the impacts of emergency care measures and medications in increasing patient survival.


2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Annisa Meivira Budiman ◽  
Sumartini Dewi ◽  
Marietta Shanti Prananta

Background Systemic sclerosis is a chronic progressive multisystem autoimmune disease in connective tissue, characterized by its heterogeneous clinical manifestation. The purpose of this study is to give information regarding clinical manifestations and laboratory findings of systemic sclerosis patients to establish diagnosis of disease. Methods This study was conducted using descriptive quantitative design in September−October 2016. Data was collected from medical records of patients visiting Rheumatology Clinic Dr. Hasan Sadikin General Hospital from 1 July 2015−30 June 2016 using total sampling method. The collected data were expected to comprise patient’s clinical manifestation and laboratory finding. Results Most of patients had cutaneous 57 (100.0%) and musculoskeletal 40 (70.2%) involvement. Some of the disease manifestations were Raynaud’s phenomenon 38 (66.7%), fingertip lesion 33 (57.9%), stiffness in skin 34 (59.6%), and arthalgia 29 (50.9%). Gastrointestinal involvements were present in 29 (50.9%) patients. Renal involvement were determined from urinalysis result showed proteinuria 10 (17.5%) and hematuria 8 (14.0%), found in 24 (42.1%) patients, while pulmonary and cardiac involvements were found in 30 (52.6%) patients, acknowledged from clinical symptoms such as dyspnea 12 (21.1%). Identification of autoantibodies was found in 12 (21.1%) patients, with 10 (17.5%) patients had reactive ANA and 3 (3.5%) had positive anti-Scl70. Conclusion Most of systemic sclerosis patients had cutaneous involvement. Renal, pulmonary, and cardiac involvement were concluded based on laboratory findings. Keywords: Systemic sclerosis, clinical manifestation, laboratory finding


2020 ◽  
Vol 8 (T1) ◽  
pp. 391-398
Author(s):  
Wienta Diarsvitri ◽  
Retno Budiarti ◽  
Pramita Anindya Nugraheni ◽  
M. Fathi Ilmawan ◽  
Verna Biutifasari

BACKGROUND: Most attention and healthcare resources in Indonesia have been geared toward battling the coronavirus (CoV) disease (COVID)-19 pandemic, and less overture has been given to the looming risks of dengue that has been endemic in many areas of Indonesia. Despite related constraints, the Primary Health Cares (PHC) in Indonesia plays an important role in the face of emergency situations. AIM: This study aimed to review the dengue and COVID-19 infection, clinical manifestations in children and adults, clinical pathology findings, as well as the prevention strategies that could be applied in PHC. METHODS: This study is a narrative review based on the research articles and reports that were published between 2010 and 2020. A total of 70 articles and reports were obtained and after careful consideration, 58 articles and reports were used as references of this study. RESULTS: Both dengue virus (DENV) and severe acute respiratory syndrome-CoV (SARS-CoV-2) share the similarity of antigenic structure, common symptoms, and laboratory findings. The immune response in SARS-CoV-2 may cause a cytokine storm, which can increase vascular permeability and organ damage. Secondary infection of DENV with different strains may allow the occurrence of antibody-dependent enhancement. The cross-reactions between SARS-CoV-2 antibodies and DENV antigens may cause false positive on rapid dengue infection serological tests. CONCLUSION: PHC as the front line of health services has a fundamental role in the crisis situation. The prevention and control of DENV and SARS-CoV-2 infections are based on the mode of transmission and need compliance to the related health protocols.


2019 ◽  
Vol 4 (3) ◽  

Introduction: Fascioliasis is a disease of the hepatobiliary system, caused by Fasciola spp that are increasing and threating of public health in the tropic areas, including of Central coastal of Vietnam. World Health Organisation estimates that at least 2.4 million people are infected in more than 70 countries worldwide, with several million at risk, and particularly, no continent is free from fascioliasis. This study carried out to evaluate several typical clinical and paracinical aspects in the pregnant women and children groups with fascioliasis. Methods: With the descriptive cross-sectional study design, and sample size in line with hospital based data. Results: the data post-analysis showed that total of 94 pregnant women and 212 child with gigantica fascioliasis were enrolled:- In the pregnant women group: the major clinical symptoms of epigastric and Chauffard Rivet triangle pain (95.74%), subshoulder muscle pain (97.87%), gastrointestinal disturbances as abdominal pain plus constipation (14.89%), loosed stool (22.34%), nausea and/or vomit (29.78%), mild fever (68%), allergic reaction with pruritis and urticaria (64.89%), mild anemia (4.26%), rare symptoms may be hepatomegaly (6.38%), chest pain, dyspnoea (43.62%), jaundice (2.13%); Laboratory parameters were positive ELISA test with Fasciola gigantica antigen (95.74%), hepatobiliary lesions by ultrasound (97.87%), majority in right liver (90.32%), eosinophilia is the predominant indicator (90.42%), In the children group: the clinical manifestations included of epigastric and Chauffard-Rivet area pain (94.34%), flatuence, nausea and intermittent vomiting (76.41%), digestive disoders (40.57%), allergy (30.66%), fatigue plus weight loss (12.74%); laboratory findings included of hepatobiliary lesions by US (100%), positive ELISA with Fasciola gigantica antigen (96.70%), eosinophil of 93.39% and 1.90% positive copro-examination with Fasciolae eggs. Conclusions: In pregnant women, symptoms are indistinguishable from hepatobiliary, digestive tract diseases or overlap with gestation terrains, and clinical signs of paediatric fascioliasis may mimic a wide spectrum of hepatobiliary disorders laboratory parameters and imaging diagnostics, especially in FasELISA, hypereosinophilia and liver lesions by ultrasound were very useful in positive diagnosis.


2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Berta Nelly Restrepo ◽  
Mark E. Beatty ◽  
Yenny Goez ◽  
Ruth E. Ramirez ◽  
G. William Letson ◽  
...  

A dengue fever surveillance study was conducted at three medical facilities located in the low-income district of San Javier in Medellin, Colombia. During March 2008 to 2009, 781 patients with fever regardless of chief complaint were recruited for acute dengue virus infection testing. Of the 781 tested, 73 (9.3%) were positive for dengue infection. Serotypes DENV-2 (77%) and -3 (23%) were detected by PCR. One patient met the diagnostic criteria for dengue hemorrhagic fever. Only 3 out of 73 (4.1%) febrile subjects testing positive for dengue infection were diagnosed with dengue fever by the treating physician. This study confirms dengue virus as an important cause of acute febrile illness in Medellin, Colombia, but it is difficult to diagnose without dengue diagnostic testing.


Author(s):  
Lili Zhou ◽  
Yuan Li ◽  
Zhufei Xu ◽  
Xuyun Peng ◽  
Xiaoyan Gong ◽  
...  

ObjectiveTo investigate the correlation between serum immunoglobulin E (IgE) levels and the complications in children with Mycoplasma pneumoniae pneumonia (MPP).MethodsA retrospective study of MPP patients hospitalized from May 2019 to July 2021 was performed. We analyzed the clinical manifestations, complications, laboratory findings, and treatments.ResultsA total of 275 patients who met the inclusion criteria were enrolled in the study. We divided patients into two groups based on whether there were complications. Complications occurred in 147 patients, of which pulmonary complications were more common than extrapulmonary complications. The IgE level in the complication group was higher than that in the non-complication group with p = 0.041. Patients with complications of necrotizing pneumonitis, pneumothorax, skin rash, or bronchiolitis obliterans had higher IgE levels. There was no statistically significant difference in IgE levels between pulmonary complications and extrapulmonary complications. The older the age, the greater the probability of complications (p = 0.001). The group with complications was more likely to have chest pain (p = 0.000), while the group without complications was more likely to have wheezing (p = 0.017). The use of bronchoscopy and glucocorticoids was higher in the complication group than in the non-complication group (p = 0.000).ConclusionsMPP patients with higher IgE levels had more severe clinical symptoms and complications. We speculated that IgE might be a biomarker for complications after MP infection.


2021 ◽  
Author(s):  
qing cai ◽  
Shoujie Wang ◽  
Min Zheng ◽  
Xuejiao Wang ◽  
Rong Liu ◽  
...  

Abstract Introduction Venous cerebral infarction is a serious complication after meningioma resection. To reduce the incidence of venous infarction, we identified risk factors for postoperative venous cerebral infarction after surgical resection of meningioma in patients with clinical symptoms.Methods The clinical and imaging data of 1127 patients with intracranial meningiomas who underwent resection in our hospital were retrospectively collected and analyzed. Venous cerebral infarction was evaluated by postoperative imaging and clinical manifestations. Univariate and multivariate analyses were performed to identify risk factors associated with venous cerebral infarction.Results Overall, 3.3% (37/1127) of patients experienced symptomatic venous cerebral infarction after meningioma resection. Multivariate analysis revealed superficial meningioma, moderate to severe peritumoral edema, peritumoral critical vein and WHO grade II-III as independent predictors of a postoperative venous cerebral infarction. After timely intervention, the symptoms were clearly alleviated in one month, and the prognosis was good, but injury to key veins could cause irreversible neurological disorders.Conclusions Intraoperative protection of veins is the primary way to prevent venous cerebral infarction. The present study identified several significant and independent risk factors for postoperative venous infarction, thereby enabling the identification of high-risk patients who require special attention during clinical and surgical management.


2020 ◽  
Vol 12 (2) ◽  
pp. 85-92
Author(s):  
Nurminha Nurminha ◽  
Tori Rihiantoro ◽  
Mara Ipa

Abstract. Clinical symptoms of dengue virus (DENV) infection range from asymptomatic mild dengue fever(DF), more severe dengue hemorrhagic fever (DHF) up to dengue shock syndrome. One of the determinantsof dengue infection severity was virus virulence. This study aimed to determine the clinical and virologicalcharacteristics of dengue virus infection patients based on the severity degree. A cross-sectional study wasconducted in RSUD Dr. H. Abdul Moeloek, Lampung Province between July-November 2016 with 56 denguepatients as samples selected using purposive sampling. The serological test was done using a rapiddiagnostic test. Blood samples for DENV serotype identification were examined using reverse-transcriptionpolymerase chain reaction. Classification of DENV infection severity was obtained from the patient’s medicalrecord. The results showed that the most common clinical manifestations were fever, headache, and retroorbitalpain, appearing in all patients from every degree of severity. There were Grade I DHF patients whoexperienced Myalgia (15.6%) and petechiae (22.2%). Laboratory results showed that thrombocytopeniaappeared in every grade, even though 13.3% of grade I patients did not experience it. Secondary infectionwas found in 92.9% of samples, and all DENV serotype can be detected in 39.2%samples: DENV-1 (46.7%),DENV-2 (6.7%), DENV-3 (26.7%), and DENV-4 (20%). This study concluded that the majority of clinicalcharacteristics in DHF patients are in line with the degree of severity, with the bleeding as the dominantmanifestation in patients with grade II-IV. Virological characteristics of DENV-1 are dominant in all patientswith DHF grade I-IV.Keywords: dengue virus, serotype, severity, secondary infection, Bandar Lampung


1989 ◽  
Vol 121 (1) ◽  
pp. 129-135 ◽  
Author(s):  
Rainer Gutekunst ◽  
Wiard Hafermann ◽  
Thomas Mansky ◽  
Peter C Scriba

Abstract. The value of ultrasonography compared with established diagnostic procedures was investigated by reviewing medical records of 92 patients (88 women and 4 men, age 11–81 years, mean age 47) with lymphocytic thyroiditis. Clinical manifestations of the disease and serum antimicrosomal antibodies and TSH were determined in all patients. The thyroid was examined by ultrasound. Both lobes were aspirated by a fine needle under sonographic control and smears examined cytologically. A total of 27 (29.3%) patients had no clinical symptoms. Antimicrocosmal antibodies were undetectable in 12 (13%) patients, 16 (17.4%) had low titres 1:32–1:100, and 64 (69.6%) ≥ 1:320. TSH (reference values 0.3–3.9 mU/l) was < 0.3 in 4 (4.3%) 0.3–3.9 in 41 (44.6%), 4–20 in 26 (28.3%), and > 20 in 21 (22.8%) patients. Ultrasound revealed a scattered sonolucent echo in 87 (94.6%) patients, and in 45 (48.9%) a normal thyroid volume (women < 18, men < 25 ml). Cytology alone was diagnostic in 84 (91.3%) patients. In conclusion, ultrasound can suggest lymphocytic thyroiditis. If antimicrosomal antibodies are undetectable or titres are not significant and/or clinical symptoms are uncertain, fine-needle aspiration can confirm the sonographic finding. Epidemiological studies including ultrasonography are necessary to obtain reliable data on the prevalence of lymphocytic thyroiditis.


2018 ◽  
Vol 73 (Suppl. 4) ◽  
pp. 18-28 ◽  
Author(s):  
Eleni Koutri ◽  
Alexandra Papadopoulou

Eosinophilic gastrointestinal diseases (EGIDs) comprise a group of chronic, inflammatory diseases of the gastrointestinal (GI) tract, that are characterized, clinically, by symptoms related to the dysfunction of the involved segment(s) of the GI tract, and histologically, by dense eosinophilic inflammation, in the absence of an identifiable secondary cause. The group of EGIDs comprises eosinophilic esophagitis (EoE), eosinophilic gastritis (EG), eosinophilic gastroenteritis (EGE), and eosinophilic colitis (EC). EoE is the most common and the best described EGID compared to EG, EGE, and EC. The clinical presentation of the EGIDs differs depending on the location and the extent of the eosinophilic infiltration in the GI tract, as well as its depth through the bowel wall. In the absence of biological markers, the diagnosis is based on the combination of clinical symptoms with the histological features of EGIDs, after the exclusion of secondary causes of eosinophilic inflammation of the GI tract. Treatment is individualized and includes elimination diets (mainly empiric or elemental) and/or drugs, according to the involved GI segment: proton pump inhibitors or local steroids in EoE; local or oral systemic steroids in EG/EGE limited to the duodenum; oral systemic steroids in EGE with lower small intestine and/or colon involvement. In patients with EoE, maintenance treatment with lower doses may be considered following histological remission with the means of drugs. In patients treated with elimination diets, disease food triggers identified during food reintroduction need to be further eliminated. Esophageal stenosis despite medical treatment requires endoscopic dilation, while the use of thiopurines or anti-TNF drugs may be considered in refractory or steroid-dependent EGID (other than EoE). The aim of this review is to provide the available evidence on each of the above disorders, to aid clinicians to interpret the clinical manifestations and the laboratory findings and choose the best available treatment option.


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