A clinical and pathological study of schistosomal nephritis.

In a Cairo clinic 17 of 41 patients with chronic pyelonephritis secondary to urinary schistosomiasis presented with classical features of the nephrotic syndrome, two-thirds being hypertensive and the majority having glomerular filtration rates within the normal range. Hypercholesterolaemia was found in one-third of the patients. Urinary sediments from these patients contained a preponderance of pus cells, red cells, granular casts, or pus casts. In addition to patches of pyelonephritis, the glomeruli showed diffuse and focal glomerulosclerosis. Electron microscopy revealed basement-membrane-like deposits in the hypertrophied axial endothelial cells and electron-dense deposits along the glomerular basement membrane. This variety of nephrotic syndrome associated with schistosomal pyelonephritis was the most common cause of nephrotic syndrome seen in the clinic.