Role of Associated Infection in Schistosomal Nephropathies

摘要

The development of a nephrotic syndrome in 44 male patents with hepatosplenicschistosomiasis and chronic salmonella infection showed a different clinical and pathological pattern when compared to nephrotic patients with hepatosplenic schistosomiasis with no bacterial infection. Forty four nephrotic patients with Salmonella-Schistosoma infection had a mean age of 19 years. Patients had oedema, prolonged low grade fever, petechial rash, hepatosplenomegaly, proteinuria, hypoalbuminaemia, normal blood pressure and serum cholesterol, and very low serum complement (C3). Percutaneous needle biopsy of the kidney showed diffuse mesangioproliferative changes (26/44); focal thickening of basement membrane in 15/44, IgM, and C3 along the basement membrane. Patients improved clinically and pathologically after treatment of schistosomiasis and salmonellosis. Renal amyloidosis was observed in 6 other patients. Two had associated chronic Salmonella paratyphi A and four had chronic urinary tract infection. Patient had normal complement components and they didn't improve treatment. Two other nephrotics were observed with chronic hepatitis B surface antigenaemia and S. mansoni infection. They were hypercholesterolaemic, had normal complement components and kidney biopsy showed membranous glomerulonephritis. Nephrotic syndrome; Glomerulonephritis; SalmonellaSchistosoma infection; Hepatosplenic schistosomiasis; Patients; Egypt.