title: Schistosoma mansoni associated glomerulopathy with IgA mesangial deposits: case report.
abstract: BACKGROUND
  Renal involvement is a severe form of schistosomiasis and occurs in 10% to 15% of patients with the hepatosplenic form of the disease. Nephrotic syndrome is the most common clinical presentation. It is a complication caused by immune complexes (IC), it is rare to appear in the Brazilian context with a immunoglobulin A (IgA) deposits. When installed the renal injury by Schistosoma mansoni, classically presents as membranoproliferative glomerulonephritis (mesangiocapillary) with lobular accentuation.
  
  
  OBJECTIVE
  To report a case of schistosomiasis nephropathy that appeared 7 years after treatment of hepatosplenic schistosomiasis with histologic pattern of mesangial proliferative glomerulonephritis with IgA deposits in mesangium. Clinically developed with progressive decrease of proteinuria with angiotensin receptor blocker (ARB).
  
  
  METHODS
  It was reported a case of a 36 years old patient, brown, with classical sintoms of nephrotic syndrome (proteinuria > 3.5 g/24h, hypoalbuminemia and hypercholesterolemia), however with hepatosplenic schistosomiasis history 7 years ago and portal hypertension. Patient underwent renal biopsy which showed IgA deposits in mesangial, being more intense than immunoglobulin G (IgG), accompanied by C1q and C3, with 4/13 glomeruli sclerotic, standard light mesangial glomerulonephritis renal injury with IgA deposits. Patient began taking ARB with progressive improvement in proteinuria.
  
  
  CONCLUSIONS
  Patients with glomerulonephritis by schistosoma don't show improvement of disease progression with antiparasitic treatment. However the anti-proteinuric treatment can slow the progression of end stage kidney disease.
authors.affiliation: Escola Superior de Ciências da Saúde, Brazil.
authors.forename: Fabiana Oliveira
authors.initials: FO
authors.lastname: Gonçalves
authors.affiliation: Secretaria e Estado de Saúde do Distrito Federal, Brazil.
authors.forename: Tânia Maria de Souza
authors.initials: TM
authors.lastname: Fontes
authors.affiliation: Escola Superior de Ciências da Saúde, Brazil.
authors.forename: Ana Paula Pereira Santana Lemes
authors.initials: AP
authors.lastname: Canuto
mesh_terms: D000328:Adult; D005260:Female; D005922:Glomerulonephritis, IGA / Q000469:parasitology*; D006801:Humans; D012555:Schistosomiasis mansoni / Q000150:complications*