Effect of anti-bilharzial treatment [praziquantel] on urothelium improvement A histopathological and immunological study

The effect of therapy by praziquantel on bilharzial urothelium was studied on 60 patients, 30 cases and 30 control. Cystoscopic and bladder biopsy was taken before and after treatment with praziquantel 40 mg/kg/ body weight for 4 doses one week apart. Cystoscopy after treatment revealed disappearance of the acute lesions: acute ulcers, edema and congestion. But no improvement of chronic lesions; and no changes were found among control group. Histopathological examination shows complete improvement of the acute lesions, granulomatous reaction, degeneration of the living ovae; but no noticeable effect upon the chronic lesions as stromal fibrosis, squamous metaplasia, and no histopathological changes shown among control group. Immunofluorescent deposition positivity was studied in bilharzial Antigen, IgM, IgA and IgG. Bilharzial antigen and IgM immunofluorscent deposition positivily can be used as a marker for detection of the response of treatment with praziquantel especially in acute lesions