J. Egypt. Soc. Parasitol. 25(1)165-173,April(1995).
Schistosomal glomerulopathy: A putative role for commonly associated salmonella infection.
Abdul-Fattah M., Yousef S. M., Ibrahim M. E., Mona E. Nasr, Hassan M. A. and Abdul-Wahab S. E.
A total of 190 patients were selected after being subjected to hemoculture for detecting Salmonella spp, coproscopy for Schistosoma mansoni egg and ELISA testing for anti schistosomal sero-reactivity. They made up 4 group; the first comprised 31 febrile patients with positive hemoculture, coproscopy and ELISA, 13 of them with hepatic fibrosis and received combined anti- typhoid and antibilharzial therapy. The second comprised 53 febrile patient with the same criteria; 18 with hepatic fibrosis, and received anti typhoid & antibilharzial alternatively. The third group comprised 46 febrile patients with positive hemoculture and negative coproscopy but with positive ELISA 20 were hepatosplenic & received anti typhoid treatment. The fourth comprised 60 afebrile patients with negative hemoculture and positive coproscopy and ELISA 35 were hepatosplenic, and received anti-bilharzial treatment. 50 healthy individuals were selected as control. The control and the patients; before and after treatment underwent investigation for determining levels of serum compleatinine3 as a marker of immune complex precipitation activity and creatinine clearance, and urinary proteins excretion in 24 hours as measurements of glomerular function. The specific treatment either combined or alternative or single in the first 3 groups consequently showed marked improvement in the above criteria with insignificant additive pattern in the second. The fourth group showed non-significant different in the above criteria after anti-bilhazial therapy among the non-hepatospatosplenic – in the group – whose criteria significantly among higher than among the hepatosplenic before treatment. These findings suggest (1) glomerulopathy in salmonella associated Schistosoma infection is mainly due to salmonella antigens with insignificant additive effect due to schistosomal antigens (2) periportal hepatic fibrosis and development of collaterals are aggravating factors in inducing immune complex diseases caused by any antigens (3) pure irreversible schistosomal glomerulopathy can be caused by active schistosoma mansoni infection only in the presence of bilharzial hepatic periportal fibrosis.
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