Barsoum R S, Bassily S, Baligh O K, Eissa M, El-Sheemy N, Affify N, Hassaballa A M
Trans R Soc Trop Med Hyg. 1977;71(5):387-91. doi: 10.1016/0035-9203(77)90035-9.
Thirty-nine cases of hepatosplenic schistosomiasis associated with renal disease are included. They were investigated for renal function, serum and urinary immunoglobulins, some serological tests, and bacteriological studies for evidence of associated salmonellosis. Renal biopsy was obtained from 23 subjects and studied by light microscopy. It was possible to distinguish two groups of cases "salmonella-negative" and "salmonella-positive". The former group was characterized by marked glomerular lesions, mainly membrano-proliferative, in different phases of evolution. Salmonella-positive cases were categorized into those with clinical, laboratory and histological evidence of interstitial nephropathy (six cases), that seems to result from salmonella pyelonephritis; and those with overt glomerular lesions (17 cases). The latter group differed from salmonella-negative cases in having mainly proliferative glomerular lesions with minimal or no basement membrane thickening; the lesions were diffuse and appeared in the same stage of evolution. The possible relation of schistosomiasis and associated salmonellosis to the pathogenesis of these lesions is discussed, suggesting an immunological basis for the glomerular injury and outlining the possible significance of hepatic fibrosis.
纳入了39例合并肾脏疾病的肝脾型血吸虫病患者。对他们进行了肾功能、血清和尿免疫球蛋白、一些血清学检查以及针对相关沙门氏菌病证据的细菌学研究。对23名受试者进行了肾活检，并通过光学显微镜进行研究。可以区分出两组病例：“沙门氏菌阴性”和“沙门氏菌阳性”。前一组的特征是肾小球病变明显，主要为膜增生性病变，处于不同的演变阶段。沙门氏菌阳性病例分为有间质性肾病临床、实验室和组织学证据的病例（6例），这似乎是由沙门氏菌肾盂肾炎引起的；以及有明显肾小球病变的病例（17例）。后一组与沙门氏菌阴性病例的不同之处在于，主要为增生性肾小球病变，基底膜增厚轻微或无增厚；病变呈弥漫性，出现在相同的演变阶段。讨论了血吸虫病及相关沙门氏菌病与这些病变发病机制的可能关系，提示肾小球损伤的免疫学基础，并概述了肝纤维化的可能意义。
