Surgical treatment in children suffering from schistosomissis mansoni includes splenectomy; ligature of left gastric vein and auto-implantation of spleen morsels into the greater omentum. The efficacy of this procedure may be responsible for the disappearance of overwhelming post-splenectomy infection (OPSI), in this kind of patients. This condition may be assigned to the lowering of IgM, circulating lymphocytes, properdin and to the absence of tutfsin, which may lead to the deficiency of mono-macrophage activity cells, responsible for bacteria adherence, phagocytosis and its destruction. PURPOSE: To analyze the functional features of the monocytes from young patients, who underwent splenectomy, ligature of left gastric vein and auto-implantation of morsels of spleen tissue on the major omentum. These patients were cared for at - University Hospital - "Serviço de Cirurgia Geral da Criança, Hospital das Clínicas, UFPE", from 1991 to 2000. METHODS: It was analyzed the rates of monocytes in vitro adherence to the solid surface and the generation of O2- radical by the monocytes, stimulated with acetate miristate of phorbol (PMA) and PMA + tuftsin, in 3 groups. The 1st group (AI), constituted by 18 patients with schistosomiasis mansoni in the hepatosplenic form and treated with splenectomy, ligature of left gastric vein and auto-implantation of fragments of spleen tissue on the major omentum; the 2nd group (ESP), formed by 09 patients with schistosomiasis mansoni in the hepatosplenic form who underwent azigo-portal disconnection with splenectomy and the 3rd one (CT) constituted by 12 voluntary teenagers from the same geographic area and with the same socio-economical conditions. RESULTS: There was no significant difference in the monocyte adherence rate among the 3 groups. With regard to the generation of O2- release, the monocytes of patients from AI group had a super oxide generation similar to that of individuals from CT group, and higher than the patients from ESP group. The monocyte treatment with tuftsin did not change the kinetic of the superoxide generation on the 3 groups. CONCLUSIONS: The monocytes of the surgical hepatosplenic schistosomiasis mansoni bearers who underwent splenectomy, ligature of the left gastric vein and auto-implantation of spleen tissue into the major omentum showed functional similar features as comparared to normal people from the same social-economical-geographical conditions.
Schistosomiasis mansoni; Monocyte; Microbe kill activity
