Immune Complex Nephropathy in Schistosomiasis

Abstract

In a patient with chronic hepatosplenic schistosomiasis a segmental sclerosing nephropathy led to terminal renal failure. The demonstration of glomerular capillary deposition of immunoglobulin and complement with electron dense deposits and lucent deformities of the glomerular basement membrane and the presence of antischistosome adult worm antibody in serum suggested that this was an example of immune complex nephropathy. Successful renal transplantation followed by niridazole treatment of the schistosomiasis induced a transient relapse of renal dysfunction with proteinuria and a fall in serum complement. The pathogenic schistosomal adult worm antigen was identified by immunofluorescence in the mesangium of the transplant; complement and immunoglobulin were present also in that site.