| Popis: |
Schistosomiasis is a tropical disease currently found in approximately 70 countries, mainly in Africa, the Eastern Mediterranean, and South America. An estimated 200 million people are infected. Schistosomiasis-associated kidney disease is not often described in the literature, and most studies show an association between the disease and glomerular alterations, especially in those patients with more severe clinical presentation. In this chapter, we review the general aspects of the disease and describe the characteristics of renal involvement in schistosomiasis mansoni. The disease is associated with high morbidity and mortality, and chronic complications are usually seen in individuals with high parasite burden, which usually occurs in those living in endemic areas. The clinical presentation of schistosomiasis results from the host’s immune response to Schistosoma eggs and the granulomatous reaction elicited by the antigens that they secrete. The immunological nature of the glomerular lesion is well established, and depends on the release of antigenic molecules produced by the parasite, triggering the formation of immune complexes that are deposited in the glomeruli. Although antigens from the adult worm are the most often related to schistosomal glomerulopathy, soluble egg antigens also contribute to the pathogenesis of glomerulopathy, as demonstrated in experimental studies. Glomerular injury is also related to the parasitosis intensity and the type and duration of the process. Membranoproliferative glomerulonephritis and focal and segmental glomerulosclerosis (FSGS) represent the patterns of glomerular injury most consistently associated with the hepatosplenic form of schistosomiasis. |
