Perfil laboratorial bioquímico e hematológico de uma população de pacientes diagnosticados com hanseníase: antes e durante a poliquimioterapia

Detalhes bibliográficos
Ano de defesa: 2007
Autor(a) principal: Silveira, Maria Irismar da Silva
Orientador(a): Alencar, Nylane Maria Nunes de
Banca de defesa: Não Informado pela instituição
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Não Informado pela instituição
Programa de Pós-Graduação: Não Informado pela instituição
Departamento: Não Informado pela instituição
País: Não Informado pela instituição
Palavras-chave em Português:
Link de acesso: http://www.repositorio.ufc.br/handle/riufc/2570
Resumo: Leprosy or Hansen’s disease is an infectious disease with slow flow velocity, transmitted by Mycobacterium leprae that attacks nerves and skin. The specific treatment for people who suffer of leprosy was emphasized in the beginning of the 80’s by the World Health Organization (WHO) in order to cure the infection with Mycobacterium leprae and prevent disability. The WHO has implemented a multidrug therapy (MDT) composed of dapsone, rifampicin and clofazimine, an association that prevents bacillus resistance. The MDT kills the bacillus, prevents the aggravation of the disease, and if followed precisely, guarantees the cure of the disease. The objective of this study was to evaluate laboratory parameters, before and during the MDT, in a population of 102 hansenian patients, aged 5 to 78 years, diagnosed and assisted at the Center of Dermatology Dona Libânia (CDERM) between January 2005 and January 2006. Evaluation of liver function (GOT, GPT, total bilirubin and fractions and alkaline phosphatase), renal function (urea and creatinine) and haematological parameters (leukogram, hematocrit and hemoglobin) was done through blood serum analysis or patient’s clinical history. A review of patient’s medical records as well as blood tests was done before treatment, after 6 months and after one year. A total of 102 patients participated on the study. Fifty patients (49%) were classified as paucibacillary (PB) and 52 (51%) multibacillary (MB). Social-demographic characteristics showed that 48 (47%) were female and 54 (53%) were male; 12 (11.7%) were either illiterate or have not finished the first grade; 6 (5,8%) were graduating; 40 (39.2%) did not have income and 34 (33.3%) earned no more than the minimum wage. Mean age was 40,8 years (SD = 19,3) and the number of patients younger than 10 years was higher in PB. As to the clinical form, 32 patients (31.3%) presented the tuberculoid form, followed by dimorph (30.3%); dimorph / tuberculoid (14.7%); Virchowian (7.8%); dimorph / Virchowian (2.9%); and undetermined (1.9%). Hematological analysis showed that anemia was the most frequent alteration, being present before and during treatment, and was most significant in the group MB in the sixth month of treatment. The most frequent alterations showed in the leukogram before and during the MDT in both PB and MB groups were lymphocytosis and eosinophilia. Regarding to biochemical parameters, that changes in the levels of GOT (5.8%) and GPT (4.9%) without statistical significance. Considering the lack of a typical laboratory profile for leprosy, the changes found in some parameters during polychemotherapy can not be attributed only to adverse effects of this therapy but to other effects that are inherent to leprosy and the use of MDT. Therefore, a safe polychemotherapy requires the realization of laboratory tests before and during treatment.
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spelling Silveira, Maria Irismar da SilvaAlencar, Nylane Maria Nunes de2012-05-04T12:36:32Z2012-05-04T12:36:32Z2007SILVEIRA, M. I. S. Perfil laboratorial bioquímico e hematológico de uma população de pacientes diagnosticados com hanseníase : antes e durante a poliquimioterapia. 2007. 88 f. Dissertação (Mestrado em Farmacologia) - Faculdade de Medicina, Universidade Federal do Ceará. Fortaleza, 2007.http://www.repositorio.ufc.br/handle/riufc/2570Leprosy or Hansen’s disease is an infectious disease with slow flow velocity, transmitted by Mycobacterium leprae that attacks nerves and skin. The specific treatment for people who suffer of leprosy was emphasized in the beginning of the 80’s by the World Health Organization (WHO) in order to cure the infection with Mycobacterium leprae and prevent disability. The WHO has implemented a multidrug therapy (MDT) composed of dapsone, rifampicin and clofazimine, an association that prevents bacillus resistance. The MDT kills the bacillus, prevents the aggravation of the disease, and if followed precisely, guarantees the cure of the disease. The objective of this study was to evaluate laboratory parameters, before and during the MDT, in a population of 102 hansenian patients, aged 5 to 78 years, diagnosed and assisted at the Center of Dermatology Dona Libânia (CDERM) between January 2005 and January 2006. Evaluation of liver function (GOT, GPT, total bilirubin and fractions and alkaline phosphatase), renal function (urea and creatinine) and haematological parameters (leukogram, hematocrit and hemoglobin) was done through blood serum analysis or patient’s clinical history. A review of patient’s medical records as well as blood tests was done before treatment, after 6 months and after one year. A total of 102 patients participated on the study. Fifty patients (49%) were classified as paucibacillary (PB) and 52 (51%) multibacillary (MB). Social-demographic characteristics showed that 48 (47%) were female and 54 (53%) were male; 12 (11.7%) were either illiterate or have not finished the first grade; 6 (5,8%) were graduating; 40 (39.2%) did not have income and 34 (33.3%) earned no more than the minimum wage. Mean age was 40,8 years (SD = 19,3) and the number of patients younger than 10 years was higher in PB. As to the clinical form, 32 patients (31.3%) presented the tuberculoid form, followed by dimorph (30.3%); dimorph / tuberculoid (14.7%); Virchowian (7.8%); dimorph / Virchowian (2.9%); and undetermined (1.9%). Hematological analysis showed that anemia was the most frequent alteration, being present before and during treatment, and was most significant in the group MB in the sixth month of treatment. The most frequent alterations showed in the leukogram before and during the MDT in both PB and MB groups were lymphocytosis and eosinophilia. Regarding to biochemical parameters, that changes in the levels of GOT (5.8%) and GPT (4.9%) without statistical significance. Considering the lack of a typical laboratory profile for leprosy, the changes found in some parameters during polychemotherapy can not be attributed only to adverse effects of this therapy but to other effects that are inherent to leprosy and the use of MDT. Therefore, a safe polychemotherapy requires the realization of laboratory tests before and during treatment.A Hanseníase é uma doença infecciosa, de evolução lenta, transmitida pelo Mycobacterium leprae que acomete nervos e pele. O tratamento específico das pessoas portadoras de hanseníase foi enfatizado no início dos anos 80 pela Organização Mundial de Saúde (OMS) com o objetivo de curar o indivíduo da infecção pelo Mycobacterium leprae e evitar o desenvolvimento de incapacidades. A OMS implementou a poliquimioterapia (PQT) composta pelas drogas dapsona, clofazimina e rifampicina, cuja associação evita a resistência medicamentosa do bacilo. A PQT mata o bacilo, evita a evolução da doença, e sendo realizada de forma completa e correta, garante a cura da doença. O objetivo geral deste estudo foi avaliar parâmetros laboratoriais antes e durante a PQT, em uma população de 102 pacientes hansênicos, com idade entre 5 e 78 anos, diagnosticados e assistidos no Centro de Dermatologia Dona Libânia (CDERM) no período de Janeiro de 2005 a Janeiro de 2006. Propomos um estudo para avaliação da função hepática (TGO, TGP, Bilirrubinas Totais e frações e Fosfatase Alcalina), renal (Uréia e Creatinina) e parâmetros hematológicos (Leucograma, Hematócrito e Hemoglobina). O estudo foi feito através da análise laboratorial no soro do paciente para avaliação da função hepática, renal e sangue total para parâmetros hematológicos. Destes, 50 (49%) pacientes foram classificados como paucibacilares (PB) e 52 (51%) multibacilares (MB). Teve como metodologia: ficha de investigação, revisão de prontuário e coleta de sangue antes de iniciar o tratamento e durante o tratamento, com 6 e 12 meses. Dentre os 102 pacientes estudados 48(47%) eram do sexo feminino e 54(53%) do sexo masculino, 12(11,7%) tinham 1º grau incompleto ou eram analfabetos e 6(5,8%) eram de nível superior. Quanto à situação financeira, 40(39,2%) não possuíam renda e 34(33,3%) ganhavam até um salário mínimo. A média da idade populacional foi de 40,8 anos (DP=19,3), entretanto a incidência de pacientes com idade inferior a 10 anos foi maior no PB. Com relação à forma clínica, 2(1,9%) eram da forma Indeterminada, 32(31,3%) Tuberculóide, 31(30,3%) Dimorfa, 15(14,7%) Dimorfa/Tuberculóide, 3(2,9%) Dimorfa/Virchowiana e 8(7,8%) da forma Virchowiana. Com relação à análise hematológica, a anemia foi a alteração mais freqüente estando presente antes e durante o tratamento, tendo sido mais significativa no grupo MB no sexto mês de tratamento. No leucograma, linfocitose e eosinofilia foram as alterações mais freqüentes antes e durante a PQT nos dois grupos PB e MB. Em relação aos parâmetros bioquímicos, foram observadas alterações nos níveis de TGO 6(5,8%) e TGP 5(4,9%) sem significância estatística. Considerando a inexistência de um perfil laboratorial característico para a hanseníase, as alterações encontradas em alguns parâmetros durante a poliquimioterapia, não podem ser atribuídas somente aos efeitos adversos deste esquema, e sim também aos efeitos inerentes à hanseníase e/ou ao uso da PQT. Para a realização de um tratamento poliquimioterápico seguro é necessária a realização de exames laboratoriais antes e durante a poliquimioterapia.HanseníaseQuimioterapia CombinadaPerfil laboratorial bioquímico e hematológico de uma população de pacientes diagnosticados com hanseníase: antes e durante a poliquimioterapiainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisporreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccessLICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://repositorio.ufc.br/bitstream/riufc/2570/2/license.txt8a4605be74aa9ea9d79846c1fba20a33MD52ORIGINAL2007_dis_missilveira.pdf2007_dis_missilveira.pdfapplication/pdf1114841http://repositorio.ufc.br/bitstream/riufc/2570/1/2007_dis_missilveira.pdf425576ef9a08e7a08eb553d5f2c95d1fMD51riufc/25702019-10-29 11:45:51.483oai:repositorio.ufc.br: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Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2019-10-29T14:45:51Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false
dc.title.pt_BR.fl_str_mv Perfil laboratorial bioquímico e hematológico de uma população de pacientes diagnosticados com hanseníase: antes e durante a poliquimioterapia
title Perfil laboratorial bioquímico e hematológico de uma população de pacientes diagnosticados com hanseníase: antes e durante a poliquimioterapia
spellingShingle Perfil laboratorial bioquímico e hematológico de uma população de pacientes diagnosticados com hanseníase: antes e durante a poliquimioterapia
Silveira, Maria Irismar da Silva
Hanseníase
Quimioterapia Combinada
title_short Perfil laboratorial bioquímico e hematológico de uma população de pacientes diagnosticados com hanseníase: antes e durante a poliquimioterapia
title_full Perfil laboratorial bioquímico e hematológico de uma população de pacientes diagnosticados com hanseníase: antes e durante a poliquimioterapia
title_fullStr Perfil laboratorial bioquímico e hematológico de uma população de pacientes diagnosticados com hanseníase: antes e durante a poliquimioterapia
title_full_unstemmed Perfil laboratorial bioquímico e hematológico de uma população de pacientes diagnosticados com hanseníase: antes e durante a poliquimioterapia
title_sort Perfil laboratorial bioquímico e hematológico de uma população de pacientes diagnosticados com hanseníase: antes e durante a poliquimioterapia
author Silveira, Maria Irismar da Silva
author_facet Silveira, Maria Irismar da Silva
author_role author
dc.contributor.author.fl_str_mv Silveira, Maria Irismar da Silva
dc.contributor.advisor1.fl_str_mv Alencar, Nylane Maria Nunes de
contributor_str_mv Alencar, Nylane Maria Nunes de
dc.subject.por.fl_str_mv Hanseníase
Quimioterapia Combinada
topic Hanseníase
Quimioterapia Combinada
description Leprosy or Hansen’s disease is an infectious disease with slow flow velocity, transmitted by Mycobacterium leprae that attacks nerves and skin. The specific treatment for people who suffer of leprosy was emphasized in the beginning of the 80’s by the World Health Organization (WHO) in order to cure the infection with Mycobacterium leprae and prevent disability. The WHO has implemented a multidrug therapy (MDT) composed of dapsone, rifampicin and clofazimine, an association that prevents bacillus resistance. The MDT kills the bacillus, prevents the aggravation of the disease, and if followed precisely, guarantees the cure of the disease. The objective of this study was to evaluate laboratory parameters, before and during the MDT, in a population of 102 hansenian patients, aged 5 to 78 years, diagnosed and assisted at the Center of Dermatology Dona Libânia (CDERM) between January 2005 and January 2006. Evaluation of liver function (GOT, GPT, total bilirubin and fractions and alkaline phosphatase), renal function (urea and creatinine) and haematological parameters (leukogram, hematocrit and hemoglobin) was done through blood serum analysis or patient’s clinical history. A review of patient’s medical records as well as blood tests was done before treatment, after 6 months and after one year. A total of 102 patients participated on the study. Fifty patients (49%) were classified as paucibacillary (PB) and 52 (51%) multibacillary (MB). Social-demographic characteristics showed that 48 (47%) were female and 54 (53%) were male; 12 (11.7%) were either illiterate or have not finished the first grade; 6 (5,8%) were graduating; 40 (39.2%) did not have income and 34 (33.3%) earned no more than the minimum wage. Mean age was 40,8 years (SD = 19,3) and the number of patients younger than 10 years was higher in PB. As to the clinical form, 32 patients (31.3%) presented the tuberculoid form, followed by dimorph (30.3%); dimorph / tuberculoid (14.7%); Virchowian (7.8%); dimorph / Virchowian (2.9%); and undetermined (1.9%). Hematological analysis showed that anemia was the most frequent alteration, being present before and during treatment, and was most significant in the group MB in the sixth month of treatment. The most frequent alterations showed in the leukogram before and during the MDT in both PB and MB groups were lymphocytosis and eosinophilia. Regarding to biochemical parameters, that changes in the levels of GOT (5.8%) and GPT (4.9%) without statistical significance. Considering the lack of a typical laboratory profile for leprosy, the changes found in some parameters during polychemotherapy can not be attributed only to adverse effects of this therapy but to other effects that are inherent to leprosy and the use of MDT. Therefore, a safe polychemotherapy requires the realization of laboratory tests before and during treatment.
publishDate 2007
dc.date.issued.fl_str_mv 2007
dc.date.accessioned.fl_str_mv 2012-05-04T12:36:32Z
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dc.identifier.citation.fl_str_mv SILVEIRA, M. I. S. Perfil laboratorial bioquímico e hematológico de uma população de pacientes diagnosticados com hanseníase : antes e durante a poliquimioterapia. 2007. 88 f. Dissertação (Mestrado em Farmacologia) - Faculdade de Medicina, Universidade Federal do Ceará. Fortaleza, 2007.
dc.identifier.uri.fl_str_mv http://www.repositorio.ufc.br/handle/riufc/2570
identifier_str_mv SILVEIRA, M. I. S. Perfil laboratorial bioquímico e hematológico de uma população de pacientes diagnosticados com hanseníase : antes e durante a poliquimioterapia. 2007. 88 f. Dissertação (Mestrado em Farmacologia) - Faculdade de Medicina, Universidade Federal do Ceará. Fortaleza, 2007.
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