HEPATOSPLENIC SCHISTOSOMIASIS - CASE-REPO RT AND CLINICAL REVIEW

Although seen rarely in Switzerland, schistosomiasis is a parasitosis affecting 200 to 250 million people round the world, mainly in tropica l and subtropical regions of Africa, Asia, Central and South America. Depending on the parasitic species, the ureters and the bladder (S. ha ematobium) or the intestine and the liver (S. mansoni, S. japonicum, S . mekongi) are primarily involved. Other organs may be affected (lung, kidneys and central nervous system). Hepatosplenic schistosomiasis re presents a special form of chronic infection by S. mansoni, S. japonic um or S. mekongi predominantly occurring in adolescents heavily and re peatedly infected during childhood, together with an additional geneti c predisposition for the disease. Hepatosplenic schistosomiasis on a w orldwide scale is one of the most prevalent causes of portal hypertens ion in man. We describe a 33-year-old Portuguese female with mansonian hepatosplenic schistosomiasis 12 years after leaving Africa, who had hepatosplenomegaly, portal hypertension, esophageal varices and hypers plenism. Splenomegaly and slight anemia had been known for years witho ut prompting further work-up. Two months before diagnosis she had been delivered of a normal child after pregnancy without portal-hypertensi ve complications, namely esophageal hemorrhage. Because of placenta ac creta, however, erythrocyte transfusion had been performed after deliv ery and was possibly responsible for hepatitis C found later on. Patho physiology, clinical findings and therapy oi the disease are discussed .