Schistosoma hematobium -associated glomerulopathy

Abstract

Schistosomiasis is the second most devastating tropical parasitic disease worldwide and is responsible for many urological complications. However, glomerular injury is a rare complication mainly described with Schistosoma mansoni. We report a case of membranoproliferative glomerulonephritis (MPGN) associated with Schistosoma hematobium infection in a young Senegalese boy living in a rural area. Clinical presentation was with steroid-resistant with nephrotic syndrome. Renal biopsy showed type 1 MPGN with the presence of S. hematobium eggs surrounded by a gigantocellular granuloma. Despite therapy with antihelminthic and immunosuppressive drugs, evolution was characterized by progression to end-stage renal disease over 1 year. More efforts should be made on the prevention and early detection of schistosomiasis among at-risk populations.

Schistosomiasis in Sub-Sahara Africa: Causes, Consequences and Control Measures for a Leading Neglected Tropical Disease

“…Rectal perforation caused by S haematobium has also been described in a case report (Seck et al, 2011). Heavy infestations are more likely to produce hepatic disease.…”

“…Patients with heavy bowel wall involvement have an increased rate of recurrent Salmonella infection, generally with positive blood cultures and negative stool cultures (Leshem et al, 2008). Chronic intestinal schistosomiasis can present with acute complications of appendicitis, perforation, and bleeding long after travel-related (or endemic) exposure (Seck et al 2011).…”

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.…”

“…There may be late deposits of IgG and IgA. Membrano-proliferative response to a direct localization of egg granuloma in kidney tissue is a rare event [25]. Because most immune complexes are non-nephritogenic, there is no correlation between overt kidney disease and low level of serum C3 [28].…”

Infectious Diseases and the Kidney in Children

“…Renal disease usually occurs in older children or young adults with long-term infection, but serious disease may also occur in young children. There have been isolated case reports of young children presenting with nephrotic syndrome secondary to Schistosoma haematobium infection directly causing membranoproliferative glomerulonephritis [198].…”