Quantitative and qualitative estimation of tissue eggs burden in bilharzial patients clinicopathological correiation

Bilharziasis is the most common endemic disease in Egypt. Sequlae of pathological lesions and their severity vary considerably. This paper will show the correlation between the intensity, of infestation with the species of ova to the production of pathology. Tissue digestion technique was used to examine 64 biopsy specimens which included two from bilharzial contracted bladders, 16 from bilharzial bladder ulcers, seven cystectomy specimens from bilharzial patients with bladder cancer, and 22 from. bilharzial ureteric strictures. Of the remaining specimens, nine were from uncomplicated bilharzial bladders and eight from simple uncomplicated bilharzial ureters. The pathological lesions were found to be due to a mixed infestation [haemotobium and mansoni] in 63.5% of the cases of ureteric strictures, 68% of chronic bladder ulcers and 100% of bilharzial contracted bladders. The infestation was due to haemotobium only in 100% of simple Bilharzial bladder cases and in 87.5% of uncomplicated ureters. Accordingly, strains of schistosoma mansoni are more productive of tissue reaction and fibrosis, which can offer [an explanation for the varied clinical picture in different people. Management of urinary tract bilharziasis should cover both haemotobium and mansoni strains

HLA system in schistosomal and non-schistosomal nephrotic syndrome

The human leucocyte antign [HLA] phenotypes [HLA, A-A, -B and -C antigens] were typed in 62 Upper Egyptian nephrotic patients and the results were compared with 400 ethnically similar normal controls. Patients were classified into 2 clinicopathological groups. Group I of 24 schistosoma hematobium associated nephrotics and group II of 38 non schistosomal nephrotic patients. Schistosoma-associated nephrotic patients showed significant association with HLA-A9, -B15 and CW3, while non schistosomal nephrotic patients showed significant association with HLA-A9, -B5, -B27 and CW3 in comparison with the control group. Nephrotic patients showed significant association with the haplotypes A9 CW3, B5 CW3 and B27 CW3 when compared to the control group. Also we found a significant linkage disequilibrium between HLA-CW3 and - HLA-A9, B5 and B-27 in the control group. We suggest that HLA-CW3 is the genuine antigen associated with nephrotic syndrome in Upper Egypt, and the associated increase in HLA-A9, -B5 and -B27 was due to their linkage disequilibrium with HLA-CW3