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The ammonia tolerance of patients in two different pathophysiological stages of hepatosplenic schistosomiasis mansoni (compensated and decompensated) was compared with that of normals and patients with cirrhosis of the liver. In addition, the histories, physical examinations, and liver function tests of these groups of patients were compared. Patients with compensated hepatosplenic schistosomiasis, all of whom had portal hypertension and esophageal varices, had relatively normal ammonia tolerance and liver function tests. They were in good physical condition and did not appear ill. Patients with decompensated hepatosplenic schistosomiasis, on the other hand, had abnormal ammonia tolerance and liver function tests and in most ways closely resembled patients with cirrhosis of the liver. These two stages of hepatosplenic schistosomiasis mansoni thus present different problems in diagnosis, prognosis and treatment.
Visiting Professor of Medicine, University of Bahia, Bahia, Brazil. From Laboratory of Parasitic Diseases, National Institutes of Health, Bethesda, Maryland. Present address: Department of Preventive Medicine, Western Reserve University, Cleveland, Ohio.
Associate Professor of Medicine, University of Bahia, Bahia, Brazil.