CLINICAL COURSE OF FOCAL SEGMENTAL GLOMERULOSCLEROSIS ASSOCIATED WITHHEPATOSPLENIC SCHISTOSOMIASIS-MANSONI

To analyze the clinical course and response to therapy 15 patients (9 male and 6 female) with the hepatosplenic form of schistosomiasis mans oni and focal segmental glomerulosclerosis (FSGS) were prospectively s tudied (mean followup=115.8+/-93.2 months). Nephrotic syndrome was the most frequent clinical presentation, followed by abnormalities of uri nalysis. The clinical course was progressive: at final evaluation 9 pa tients (60%) had developed renal failure. Hypertension or/and renal in sufficiency at initial evaluation and persistence of the nephrotic syn drome were associated with progression toward advanced renal failure. Response to immunosuppressive therapy was recorded in 30% of the patie nts; all responsive patients still had normal renal function at final evaluation. The treatment of the Schistosoma mansoni infection did not influence the clinical course of the renal disease. It is concluded t hat FSGS in patients with hepatosplenic schistosomiasis mansoni is a d isease progressing to advanced stage independently of the presence of the parasite.