Nephropathy in asymptomatic patients with active schistosoma mansoni infection

Abstract

In this study 240 patients with active Schistosoma mansoni infection with no symptoms suggestive of glomerular disease were subjected to investigation. All were evaluated clinically and their urine was examined for proteinuria. Out of the 240 patients 48 (20%) had proteinuria as detected by the dipstick test. All these patients were found to be free of any secondary cause other than schistosomiasis which could explain their proteinuria. Out of these 48 patients, 15 agreed to be subjected to kidney biopsy. When examined by light microscopy and immunofluorescent microscopy, kidney biopsies showed positive findings in 8 cases. These were mainly focal mesangial proliferation and immunofluorescent deposits which were mainly IgM and C3. We have concluded that early kidney lesions could be detected in 20% of this particular group of patients.

Urinary schistosomiasis

“…Apparently due to the greater occurrence of subclinical disease in patients with S. hematobium, a higher prevalence of glomerular disease is often reported in those infected with S. mansoni (Tables 1, 2) [25][26][27]. SGN manifests as a clinical, spectrum of asymptomatic, proteinuria, nephrosis and/or nephritic syndrome.…”

“…esnonline.net]. Immune complex deposits (IgM, C3, and C1q) containing adult worm antigens (gut-associated proteoglycan) in the glomerulus are the early pathological features [27]. There may be late deposits of IgG and IgA.…”

Localization by Immunoelectron Microscopy of Schistosoma mansoni Antigens in the Glomerulus of the Hamster (Mesocricetus auratus) Kidney

“…Both human and experimental studies point to the mesangial area of the glomerulus as the main site of lesions in schistosomal nephropathy [23, 24, 25, 26, 27]. The mesangium is a ready depository for a variety of circulating macromolecules, including potential antigens and preformed immune complexes [28].…”

Schistosomal glomerulopathy and changes in the distribution of histological patterns of glomerular diseases in Bahia, Brazil

“…Class I (mesangioproliferative glomerulonephritis) may be the most prevalent form of schistosomal glomerulopathy seen in patients with hepato-intestinal or hepatosplenic schistosomiasis (Sobh et al 1990). Patients with this form of the disease are clinically normal or they may present mild proteinuria or nephrotic syndrome.…”