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日本血吸虫感染与膜性肾病相关:一例报告。

Schistosoma japonicum infection associated with membranous nephropathy: a case report.

机构信息

Department of Nephrology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.

Department of Nephropathology, Xiangya Hospital, Central South University, Changsha, China.

出版信息

BMC Infect Dis. 2022 Feb 5;22(1):125. doi: 10.1186/s12879-022-07092-0.

Abstract

BACKGROUND

Schistosomiasis is one of the most contagious parasitic diseases affecting humans; however, glomerular injury is a rare complication mainly described with Schistosoma mansoni infection. We report a case of membranous nephropathy associated with Schistosoma japonicum infection in a Chinese man.

CASE PRESENTATION

A 51-year-old Chinese male with a long history of S. japonicum infection presented to the hospital with a slowly progressing severe lower limb edema and foaming urine for over 5 months. Serum S. japonicumantigen test was positive and immunohistochemistry showed that the glomeruli were positive for the antigens. The renal pathologic diagnosis was stage III membranous nephropathy. The patient was treated with glucocorticoid, praziquantel, and an angiotensin-converting enzyme inhibitor. The edema in both lower limbs disappeared within 2 weeks, but his renal function declined progressively and proteinuria persisted after 5 months of therapy.

CONCLUSIONS

Different classes of schistosomal glomerulopathy have completely different clinical manifestation and prognosis. Therefore, efforts should focus on alleviating symptoms, prevention, and early detection. S. japonicumassociated with membranous nephropathy may show a good curative effect and prognosis. However, it is necessary to monitor the renal function in such patients.

摘要

背景

血吸虫病是一种最具传染性的人类寄生虫病;然而,肾小球损伤是一种罕见的并发症,主要与曼氏血吸虫感染有关。我们报告了一例与日本血吸虫感染相关的膜性肾病的中国男性病例。

病例介绍

一名 51 岁的中国男性,有长期的日本血吸虫感染史,因下肢进行性严重水肿和泡沫尿超过 5 个月而就诊。血清日本血吸虫抗原检测阳性,免疫组化显示肾小球抗原阳性。肾脏病理诊断为 III 期膜性肾病。患者接受了糖皮质激素、吡喹酮和血管紧张素转换酶抑制剂治疗。双下肢水肿在 2 周内消失,但治疗 5 个月后肾功能逐渐下降,蛋白尿持续存在。

结论

不同类别的血吸虫肾小球病具有完全不同的临床表现和预后。因此,应努力缓解症状、预防和早期发现。与膜性肾病相关的日本血吸虫可能表现出良好的疗效和预后。然而,有必要监测此类患者的肾功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8894/8818173/871e03e297c5/12879_2022_7092_Fig1_HTML.jpg

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