Pancreatic involvement in fatal human leptospirosis: clinical and histopathological features

Detalhes bibliográficos
Autor(a) principal: Daher, Elizabeth De Francesco
Data de Publicação: 2003
Outros Autores: Brunetta, Denise Menezes, Silva Júnior, Geraldo Bezerra da, Puster, Rainardo Antonio, Patrocínio, Régia Maria do Socorro Vidal
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista do Instituto de Medicina Tropical de São Paulo
Texto Completo: https://www.revistas.usp.br/rimtsp/article/view/30760
Resumo: Hyperamylasemia has been reported in more than 65% of patients with severe leptospirosis, and the true diagnosis of acute pancreatitis is complicated by the fact that renal failure can increase serum amylase levels. Based on these data we retrospectively analyzed the clinical and histopathological features of pancreas involvement in 13 cases of fatal human leptospirosis. The most common signs and symptoms presented at admission were fever, chills, vomiting, myalgia, dehydratation, abdominal pain and diarrhea. Trombocytopenia was evident in 11 patients. Mild increased of AST and ALT levels was seen in 9 patients. Hyperamylasemia was recorded in every patient in whom it was measured, with values above 180 IU/L (3 cases). All patients presented acute renal failure and five have been submitted to dialytic treatment. The main cause of death was acute respiratory failure due to pulmonary hemorrhage. Pancreas fragments were collected for histological study and fat necrosis was the criterion used to classify acute pancreatitis. Histological pancreatic findings were edema, mild inflammatory infiltrate of lymphocytes, hemorrhage, congestion, fat necrosis and calcification. All the patients infected with severe form of leptospirosis who develop abdominal pain should raise the suspect of pancreatic involvement.
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spelling Pancreatic involvement in fatal human leptospirosis: clinical and histopathological features Acometimento pancreático em casos fatais de leptospirose humana: aspectos clínicos e histopatológicos PancreatitisLeptospirosisAcute renal failureHyperamylasemia Hyperamylasemia has been reported in more than 65% of patients with severe leptospirosis, and the true diagnosis of acute pancreatitis is complicated by the fact that renal failure can increase serum amylase levels. Based on these data we retrospectively analyzed the clinical and histopathological features of pancreas involvement in 13 cases of fatal human leptospirosis. The most common signs and symptoms presented at admission were fever, chills, vomiting, myalgia, dehydratation, abdominal pain and diarrhea. Trombocytopenia was evident in 11 patients. Mild increased of AST and ALT levels was seen in 9 patients. Hyperamylasemia was recorded in every patient in whom it was measured, with values above 180 IU/L (3 cases). All patients presented acute renal failure and five have been submitted to dialytic treatment. The main cause of death was acute respiratory failure due to pulmonary hemorrhage. Pancreas fragments were collected for histological study and fat necrosis was the criterion used to classify acute pancreatitis. Histological pancreatic findings were edema, mild inflammatory infiltrate of lymphocytes, hemorrhage, congestion, fat necrosis and calcification. All the patients infected with severe form of leptospirosis who develop abdominal pain should raise the suspect of pancreatic involvement. Hiperamilasemia tem sido documentada em mais de 65% dos pacientes com leptospirose severa, e o diagnóstico de pancreatite aguda torna-se difícil pelo fato de que a insuficiência renal pode aumentar os níveis séricos de amilase. Assim, foram analisadas, retrospectivamente, as características clínicas e histopatológicas do acometimento pancreático em 13 casos fatais de leptospirose humana. Os sinais e sintomas mais comuns foram febre, calafrios, vômitos, mialgia, desidratação, dor abdominal e diarréia. Trombocitopenia foi encontrada em 11 pacientes. Elevação dos níveis de AST e ALT foi observada em nove casos. Hiperamilasemia foi detectada em todos os pacientes em que foi dosada, com valores acima de 180 UI/L (três casos). Todos os pacientes desenvolveram insuficiência renal aguda e cinco necessitaram de tratamento dialítico. A principal causa de morte foi insuficiência respiratória devido à hemorragia pulmonar. Fragmentos do pâncreas foram obtidos para estudo histológico, e necrose gordurosa foi o critério utilizado para classificar pancreatite. Os achados histológicos foram edema pancreático, infiltrado inflamatório discreto de linfócitos, hemorragia, congestão, necrose gordurosa e calcificação. Deve-se suspeitar de acometimento pancreático em todo paciente com a forma grave de leptospirose que desenvolve dor abdominal. Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo2003-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rimtsp/article/view/30760Revista do Instituto de Medicina Tropical de São Paulo; Vol. 45 No. 6 (2003); 307-313 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 45 Núm. 6 (2003); 307-313 Revista do Instituto de Medicina Tropical de São Paulo; v. 45 n. 6 (2003); 307-313 1678-99460036-4665reponame:Revista do Instituto de Medicina Tropical de São Pauloinstname:Instituto de Medicina Tropical (IMT)instacron:IMTenghttps://www.revistas.usp.br/rimtsp/article/view/30760/32644Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Pauloinfo:eu-repo/semantics/openAccessDaher, Elizabeth De FrancescoBrunetta, Denise MenezesSilva Júnior, Geraldo Bezerra daPuster, Rainardo AntonioPatrocínio, Régia Maria do Socorro Vidal2012-07-07T18:06:49Zoai:revistas.usp.br:article/30760Revistahttp://www.revistas.usp.br/rimtsp/indexPUBhttps://www.revistas.usp.br/rimtsp/oai||revimtsp@usp.br1678-99460036-4665opendoar:2022-12-13T16:51:30.973532Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT)true
dc.title.none.fl_str_mv Pancreatic involvement in fatal human leptospirosis: clinical and histopathological features
Acometimento pancreático em casos fatais de leptospirose humana: aspectos clínicos e histopatológicos
title Pancreatic involvement in fatal human leptospirosis: clinical and histopathological features
spellingShingle Pancreatic involvement in fatal human leptospirosis: clinical and histopathological features
Daher, Elizabeth De Francesco
Pancreatitis
Leptospirosis
Acute renal failure
Hyperamylasemia
title_short Pancreatic involvement in fatal human leptospirosis: clinical and histopathological features
title_full Pancreatic involvement in fatal human leptospirosis: clinical and histopathological features
title_fullStr Pancreatic involvement in fatal human leptospirosis: clinical and histopathological features
title_full_unstemmed Pancreatic involvement in fatal human leptospirosis: clinical and histopathological features
title_sort Pancreatic involvement in fatal human leptospirosis: clinical and histopathological features
author Daher, Elizabeth De Francesco
author_facet Daher, Elizabeth De Francesco
Brunetta, Denise Menezes
Silva Júnior, Geraldo Bezerra da
Puster, Rainardo Antonio
Patrocínio, Régia Maria do Socorro Vidal
author_role author
author2 Brunetta, Denise Menezes
Silva Júnior, Geraldo Bezerra da
Puster, Rainardo Antonio
Patrocínio, Régia Maria do Socorro Vidal
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Daher, Elizabeth De Francesco
Brunetta, Denise Menezes
Silva Júnior, Geraldo Bezerra da
Puster, Rainardo Antonio
Patrocínio, Régia Maria do Socorro Vidal
dc.subject.por.fl_str_mv Pancreatitis
Leptospirosis
Acute renal failure
Hyperamylasemia
topic Pancreatitis
Leptospirosis
Acute renal failure
Hyperamylasemia
description Hyperamylasemia has been reported in more than 65% of patients with severe leptospirosis, and the true diagnosis of acute pancreatitis is complicated by the fact that renal failure can increase serum amylase levels. Based on these data we retrospectively analyzed the clinical and histopathological features of pancreas involvement in 13 cases of fatal human leptospirosis. The most common signs and symptoms presented at admission were fever, chills, vomiting, myalgia, dehydratation, abdominal pain and diarrhea. Trombocytopenia was evident in 11 patients. Mild increased of AST and ALT levels was seen in 9 patients. Hyperamylasemia was recorded in every patient in whom it was measured, with values above 180 IU/L (3 cases). All patients presented acute renal failure and five have been submitted to dialytic treatment. The main cause of death was acute respiratory failure due to pulmonary hemorrhage. Pancreas fragments were collected for histological study and fat necrosis was the criterion used to classify acute pancreatitis. Histological pancreatic findings were edema, mild inflammatory infiltrate of lymphocytes, hemorrhage, congestion, fat necrosis and calcification. All the patients infected with severe form of leptospirosis who develop abdominal pain should raise the suspect of pancreatic involvement.
publishDate 2003
dc.date.none.fl_str_mv 2003-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/rimtsp/article/view/30760
url https://www.revistas.usp.br/rimtsp/article/view/30760
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.revistas.usp.br/rimtsp/article/view/30760/32644
dc.rights.driver.fl_str_mv Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Paulo
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Paulo
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo
publisher.none.fl_str_mv Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo
dc.source.none.fl_str_mv Revista do Instituto de Medicina Tropical de São Paulo; Vol. 45 No. 6 (2003); 307-313
Revista do Instituto de Medicina Tropical de São Paulo; Vol. 45 Núm. 6 (2003); 307-313
Revista do Instituto de Medicina Tropical de São Paulo; v. 45 n. 6 (2003); 307-313
1678-9946
0036-4665
reponame:Revista do Instituto de Medicina Tropical de São Paulo
instname:Instituto de Medicina Tropical (IMT)
instacron:IMT
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reponame_str Revista do Instituto de Medicina Tropical de São Paulo
collection Revista do Instituto de Medicina Tropical de São Paulo
repository.name.fl_str_mv Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT)
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