Submitted by Edisangela Bastos (edisangela@ufpa.br) on 2013-03-19T22:46:57Z No. of bitstreams: 2 license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Dissertacao_CorrelacaoClinicoLaboratorial.pdf: 37431500 bytes, checksum: 9f36cdb930e05a4abda9b6adb64fd372 (MD5) / Approved for entry into archive by Ana Rosa Silva(arosa@ufpa.br) on 2013-03-20T12:54:07Z (GMT) No. of bitstreams: 2 license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Dissertacao_CorrelacaoClinicoLaboratorial.pdf: 37431500 bytes, checksum: 9f36cdb930e05a4abda9b6adb64fd372 (MD5) / Made available in DSpace on 2013-03-20T12:54:07Z (GMT). No. of bitstreams: 2 license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Dissertacao_CorrelacaoClinicoLaboratorial.pdf: 37431500 bytes, checksum: 9f36cdb930e05a4abda9b6adb64fd372 (MD5) Previous issue date: 2001 / O diagnóstico clínico da amebíase intestinal continua sendo meramente presuntivo; o diagnóstico de certeza depende sempre de confirmação laboratorial. Com o objetivo de correlacionar os achados clínicos com a pesquisa do coproantígeno GIAP de Entamoeba histolytica, por teste imunoenzimático, foram estudados 105 pacientes de ambos os sexos, com idade entre 13 e 18 anos, provenientes de demanda passiva do Serviço Ambulatorial de Clínica Médica da Polícia Militar. A prevalência de amebíase intestinal encontrada por coproscopia foi de 13,33% (14/105) e por ELISA 24,76% (26/105). Houve diferença estatisticamente significativa na prevalência desta protozoose quando os métodos foram comparados (p<0,05-McNemar). Entre os enteroparasitas detectados por métodos coproscópicos de rotina destacaram-se: Endolimax nana com 61,90% (65/105), Blastocystis hominis 28,57% (30/105), Entamoeba coli 18,10% (19/105) e Giardia amblia em 5,71 (06/105). Entre os helmintos, os mais prevalentes foram o Trichiuris.trichiura com 4,76% (5/105) e de Ascaris lumbricoides em 3,81% (4,105). A prevalência dessas parasitoses na população estudada foi compatível com a casuística regional. No estudo da sintomatologia dos pacientes com teste de ELISA positivo, 73,08% (19/26) relataram um ou mais sintomas sugestivos de amebíase intestinal, observando-se cólicas intestinais em 46,15% (12/26), diarréia sem elementos anormais em 42,31% (11/26), tenesmo em 3,85% (1/26) e constipação intestinal em 11,54% (3/26). A presença desses sintomas quando comparada com os casos clinicamente idênticos, porém com teste de ELISA não apresentaram significância estatística (p<0,05-McNemar). Quanto a diarréia mucossanguinolenta, esta foi referida por 4,76% de apresentação das síndromes clínicas e sua amplitude de diagnósticos diferenciais, aliados às possibilidades de equívocos que os métodos diagnósticos usualmente empregados podem fornecer. Recomenda-se a inclusão do teste de ELISA no diagnóstico da amebíase intestinal como um recurso indispensável na clínica, embora ele não dispense o exame coproparasitológico, por ser capaz de indetificar somente um patógeno, a E. histolyca. / Intestinal amoebiasis clinical diagnosis remains presumable and the correct diagnosis always need laboratorial confirmation. A hundred-five patients, of both sexes, age between 13 - 80 years-old, from passive demand of "Serviço Ambulatorial de Clínica Medica da Polícia Militar", were selected for this study in order to correlate the clinical findings and imunoenzimatic E. histolytica GIAP stool antigen search. The prevalence of intestinal amoebiasis was 13,33% (14/105) for single stool examination and 24,76% (26/105) for ELISA. When the two methods were compared, diference statistically significant it was found (p < 0,05 - McNemar). Among detected parasites by single stool examination: Endolimax. nana with 61,90% (65/105), Blastocystis hominis 28,57% (30/105). Entamoeba coli 18,10% (19/105) and Giardia lamblia 5,71% (6/105) were the most prevalent. Trichiuris trichiura with 4.76% (5/105) and A lumbricoides 3,81% (4/105) had the highest prevalence among helminths. The prevalence of such parasitic infections at the studied population was according to local casuistic. In the analysis of the symptomatology of ELISA positive patients, 73,08% (19/26) had reported one or more disease suggestive symptoms, and was observed abdominal pain in 46,15% (12/26) patients, diarrhoea with no abnormal elements in 42,31 % (11/26), tenesmus in 3,85% (1/26) and intestinal constipation 11,54% (3/26). The presence of such symptons when compared with clinical similar cases ELISA negative, were not significative (p > 0,05 - McNermar). In 4,76% patients (5/105), diarrhoea with mucosus and blood was refered. This association with ELISA positive test were observed in 3,84% (1/26), and was statistically significative when compared with ELISA negative ones. The results of this work shows the difficulties in establishing the clinics and laboratory correlation in intestinal amoebiasis. It occurs because of clinical syndroms are not so specifie and the need of different diagnosis, together to the error possibility in routine diagnosis methods. Its is suggested the inclusion of ELISA test in intestinal amoebiasis diagnosis as a necessary clinical resource although, it does not exclude the single stool examination to others parasites, due to be able to identify only the pathogen, Entamoeba histolytica.