Renal changes in patients with hepatosplenic schistosomiasis.

Abstract

Patients with hepatosplenic schistosomiasis present frequent urinary changes, and glomerulonephritis is significantly prevalent. Glomerulosclerotic changes similar to those found in hepatic cirrhosis also occur in advanced schistosomiasis. A histopathological survey of kidney sections from a large series of necropsies showed definite glomerulosclerotic changes present in 36.2% of cases of hepatosplenic schistosomiasis and in 26.6% of cirrhotics. Similar changes were not seen in mild schistosomiasis. In four cases of hepatosplenic schistosomiasis, the diffuse glomerulosclerotic changes were associated with focal glomerulonephritis, which involved about 10% of glomeruli. These changes could represent a transition to diffuse glomerulonephritis. Classical diffuse glomerulonephritis was present in 10% of the cases with hepatosplenic schistosomiasis and was absent in the cases with cirrhosis and mild schistosomiasis. The present study revealed that renal glomeruli are frequently altered histologically in patients with hepatosplenic schistosomiasis and that these alterations seem to represent a spectrum of changes that include mesangial cell proliferation, deposition of mesangial matrix, glomerulosclerosis, and glomerulonephritis.