Thrombocytemia as a predictor of portal hypertension in schistosomiasis.

Sufferers of schistosomiasis mansoni can evolve a clinical form of the disease associated with portal hypertension. To differentiate this form, routine clinical tests and biological indices were evaluated. In all, 54 HBsAg- and HCV-negative patients were studied, 42 with schistosomiasis and 12 normal volunteers. Using clinical criteria, ultrasonography, and endoscopy, the schistosomiasis patients were classified into two groups: mild chronic form (MS, N = 14) and chronic form associated with portal hypertension (PH, N = 28). The laboratory parameters of the MS group did not differ from the controls. The PH group differed from the others in prothrombin index, thrombocytemia, gamma-glutamyltransferase, serum alpha2-macroglobulin, and the calculated indices. ROC plot cutoff levels verified that isolated thrombocytemia was the most efficient marker for discrimination of the PH and MS forms. Thrombocytemia of 130 x 10(9) platelets/liter discriminated the groups with an 86% accuracy when all patients were analyzed and 96% when only schistosomiasis patients who did not consume alcohol were included.