XI International Meeting on Paracoccidioidomycosis
Resume:146-1


Investigação
146-1Liver paracoccidioidomycosis in children
Authors:Ricardo Mendes Pereira (FCM UNICAMP - Faculdade de Ciencias Medicas UNICAMP)

Abstract

The Paracoccidioidmycosis is rare in pediatrics with few descriptions of the clinical presentation and especially the hepatic involvement. The objective of this paper was to present 41 cases of liver paracoccidioiomycosis in patients younger than 16 years and compare the clinical presentation, laboratory and evolution in Pediatric Patients with paracoccidioidomycosis without hepatic involvement. We observed that patients with liver involvement have significantly lower age, higher number of male patients and a higher proportion of undernourished. Clinical manifestations of weight loss, malaise, anorexia, pallor, and splenomegaly were more frequent among patients with liver involvement. When comparing the results of the complete blood count in relation to liver involvement there was a lower hemoglobin concentration, lower lymphocyte count and platelet counts with statistical difference. In relation to serum protein electrophoresis to compare the groups showed, with statistical difference, lower albumin concentration. The results of multivariate logistic regression shows a combined influence of albumin on admission (every 1 unit of albumin on admission the risk of liver involvement decreases 81.8%, or every reduction of 1 unit albumin on admission the risk of liver involvement increases 5.5 times (OR = 5.49) and age (every 1 year of age the risk of liver involvement decreases 23.5%, or every reduction of 1 year of age the risk of liver involvement increases 30.7% (OR = 1.31). The results of ROC curve analysis for laboratory tests on admission, using the liver involvement as the gold standard, show that it is possible to establish cutoff levels from which the liver involvement is more likely for the variables albumin (≤ 3.05 g / dL), hemoglobin (≤ 9.2 g / dL) and lymphocytes (≤ 2508/mm3). This study showed that it is possible to predict the hepatic involvement by Paracoccidioides brasiliensis using clinical data (age) and laboratory (albumin, hemoglobin and lymphocytes).਀㰀⼀昀漀渀琀㸀㰀⼀瀀㸀㰀戀爀㸀㰀戀㸀䬀攀礀眀漀爀搀㨀 㰀⼀戀㸀☀渀戀猀瀀㬀氀椀瘀攀爀Ⰰ 瀀愀爀愀挀漀挀挀椀搀椀漀椀搀漀洀礀挀漀猀椀猀Ⰰ 愀氀戀甀洀椀渀Ⰰ 栀攀洀漀最氀漀戀椀渀Ⰰ 挀栀椀氀搀爀攀渀㰀⼀琀搀㸀㰀⼀琀爀㸀㰀⼀琀愀戀氀攀㸀㰀⼀琀爀㸀㰀⼀琀搀㸀㰀⼀琀愀戀氀攀㸀㰀⼀戀漀搀礀㸀㰀⼀栀琀洀氀㸀