Daily urinary protein loss in Schistosoma haematobium infection.

Proteinuria was studied in 128 children aged 6 to 18 years with Schistosoma haematobium infection in the People's Republic of Congo. Urinary protein concentration in spontaneously voided midday urine of patients with greater than 100 ova/10 ml was significantly higher than in 24-hr urine specimens. Median daily urinary protein loss in patients with moderate intensity of infection (100-350 ova/10 ml) was 300 mg and 584 mg/1.73 m2 body surface in heavily infected patients (greater than 350 ova/10 ml). A significant correlation existed between egg excretion at noon and protein concentration in spontaneous urine samples as well as daily urinary protein loss (r = 0.76 and r = 0.68, respectively). Heavily infected patients had a daily protein loss of up to 3.3 g/1.73 m2, total serum protein and albumin concentration, however, were within normal limits. This may indicate adaptive mechanisms in patients with urinary schistosomiasis and high proteinuria which maintain a balanced serum protein concentration.

Ultrasonographic findings in the livers of patients with lepromatous leprosy.

Abdominal ultrasonography, including assessment of the liver, spleen, pancreas, great abdominal vessels, and kidneys, was carried out in seven patients with lepromatous leprosy, six patients with tuberculoid leprosy, and 32 healthy Congolese controls. Abnormal ultrasound findings were predominantly detected in the livers of patients with lepromatous leprosy and included an inhomogeneous echo texture of the hepatic parenchyma in all cases. Furthermore, six patients revealed echo-dense, partly irregular areas up to 1.5 cm X 3 cm in size distributed throughout the liver. These were associated with shadowing and were considered to contain calcium. No abnormal findings were encountered in controls or in patients with tuberculoid leprosy except for one patient with tuberculoid leprosy who had a rounded caudal liver edge. The sizes and volumes of liver, spleen, and kidneys were not different in the three groups.

Reduction of pathological findings in urine and bladder lesions in infection with Schistosoma haematobium after treatment with praziquantel.

Egg output, proteinuria, erythrocyturia, and leukocyturia were quantitatively assessed in six schoolchildren with urinary schistosomiasis due to Schistosoma haematobium on 5 days before and 1-35 and 61-65 days after administration of praziquantel (40 mg/kg). Twenty days after therapy, egg output had decreased from a median of 310 before therapy to less than one egg per 10 ml of urine. This decrease was paralleled by a reduction in proteinuria (1.01 g/liter), erythrocyturia (2,142/microliter), and leukocyturia (803/microliter) to normal values. Between days 31-35 and 61-65, five of the six patients had no detectable viable eggs on five consecutive days. Thickening of the bladder wall and vesical polyps detected by ultrasonography returned to a normal appearance one month after treatment. However, dilatation of the renal collecting system showed no significant reduction.

Morbidity in urinary schistosomiasis: relation between sonographical lesions and pathological urine findings.

213 patients with urinary schistosomiasis were investigated under field conditions in the Peoples Republic of Congo by quantitative parasitological examination, urine analysis and abdominal ultrasonography. The study group consisted mainly of children. Disease related pathological ultrasonographical findings were dependent on the intensity of infection. Sixty patients had bladder wall thickening and 55 patients had vesical polyps. Those with multiple vesical polyps were the only patients with urinary retention and they had a significantly higher proteinuria than those with a singular polyp. Obstructive uropathy of different degrees was encountered in 50 cases. Of these, 21 patients had moderate to severe urinary tract obstruction and in all cases except one also presented concomitant vesical abnormalities. Nine patients revealed bilateral obstructive uropathy. Lesions of the lower urinary tract were a predisposing factor in the development of urinary tract obstruction. Morbidity of study patients was considered to be substantial. A proteinuria of more than one gramme per litre in spontaneously voided midday urine indicated a high probability for the presence of urinary tract obstruction and was considered an urgent indication for antischistosomal treatment.