Is the coagulopathy of hepatosplenic schistosomiasis immune-related?

Some of the soluble factors that affect haemostasis produced in the course of hepatosplenic schistosomiasis, including endotoxins (Ex), interleukin-1 alpha (IL-1 alpha) and tumour necrosis factor-alpha (TNF-alpha) were studied. Forty-one patients with hepatosplenic schistosomiasis were studied and classified into early hepatosplenic schistosomiasis (n = 12), hepatocellular decompensation (n = 14), vascular decompensation (n = 15) as well as twelve healthy controls. Thrombin-antithrombin complex (TAT), protein C and free protein S antigen and activity, endotoxin, IL-1 alpha and TNF-alpha levels were measured in all cases. Evidence of enhanced thrombin generation (elevated TAT levels) with reduced anticoagulant potential (reduced protein C and free protein S antigen and activity levels) could be demonstrated, thus reflecting decreased production and increased consumption of both coagulant and anticoagulant proteins. The association of high Ex, IL-1 alpha and TNF-alpha levels may suggest their possible implication in the causation of intravascular coagulation in hepatosplenic schistosomiasis.