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.
METHODS: 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.
METHODS: 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：血吸虫病是影响人类的传染性最强的寄生虫病之一；然而，肾小球损伤是一种罕见的并发症，主要描述为曼氏血吸虫感染。我们报告了一名中国男子与日本血吸虫感染相关的膜性肾病病例。
方法：一名51岁的中国男性，有很长的日本血吸虫感染史，出现缓慢进展的严重下肢水肿，并有超过5个月的泡沫尿液。血清日本血吸虫抗原试验阳性，免疫组织化学显示肾小球抗原阳性。肾脏病理诊断为III期膜性肾病。患者接受糖皮质激素治疗，吡喹酮,和血管紧张素转换酶抑制剂。2周内双下肢水肿消失，但治疗5个月后肾功能逐渐下降,蛋白尿持续存在.
结论：不同类型的血吸虫肾小球病具有完全不同的临床表现和预后。因此,努力应该集中在缓解症状上，预防,和早期检测。日本血吸虫合并膜性肾病可能显示出良好的疗效和预后。然而,有必要监测这些患者的肾功能。
方法：一名51岁的中国男性，有很长的日本血吸虫感染史，出现缓慢进展的严重下肢水肿，并有超过5个月的泡沫尿液。血清日本血吸虫抗原试验阳性，免疫组织化学显示肾小球抗原阳性。肾脏病理诊断为III期膜性肾病。患者接受糖皮质激素治疗，吡喹酮,和血管紧张素转换酶抑制剂。2周内双下肢水肿消失，但治疗5个月后肾功能逐渐下降,蛋白尿持续存在.
结论：不同类型的血吸虫肾小球病具有完全不同的临床表现和预后。因此,努力应该集中在缓解症状上，预防,和早期检测。日本血吸虫合并膜性肾病可能显示出良好的疗效和预后。然而,有必要监测这些患者的肾功能。
