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

Memórias do Instituto Oswaldo Cruz

Washington Luis Conrado Dos-santos²  Glória Maria Maranhão Sweet²  Marília Bahiense-oliveira¹  Paulo Novis Rocha¹ 

[1] ,Moniz-Fiocruz Centro de Pesquisas Gonçalo Salvador BA ,Brasil

关键词: schistosomiasis;    Schistosoma mansoni;    Schistosoma japonicum;    mesangiocapillary glomerulonephritis;    kidney diseases;    focal segmental glomerulosclerosis;   

DOI  :  10.1590/S0074-02762011000700017

来源: SciELO

【 摘 要 】

Distinct patterns of glomerular lesions, including membranoproliferative glomerulonephritis and focal segmental glomerulosclerosis, are associated with infection by Schistosoma mansoni or Schistosoma japonicum. Evidence suggests that immune complex deposition is the main mechanism underlying the different forms of schistosomal glomerulonephritis and that immune complex deposition may be intensified by portal hypertension. The relationship between focal segmental glomerulosclerosis and schistosomiasis remains poorly understood. A clinicopathologic classification of schistosomal glomerulopathies was proposed in 1992 by the African Association of Nephrology. In Brazil, mass treatment with oral medications has led to a decrease in the occurrence of schistosomal glomerulopathy. In a survey of renal biopsies performed in Salvador, Brazil, from 2003-2009, only 24 (4%) patients were identified as positive for S. mansoni infection. Among these patients, only one had the hepatosplenic form of the disease. Focal segmental glomerulosclerosis was found in seven patients and membranoproliferative glomerulonephritis was found in four patients. Although retrospective studies on the prevalence of renal diseases based on kidney biopsies may be influenced by many patient selection biases, a change in the distribution of glomerulopathies associated with nephrotic syndrome was observed along with a decline in the occurrence of severe forms of schistosomiasis.

【 授权许可】

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