What causes Pipestem fibrosis?

What causes Pipestem fibrosis?

Pathogenesis of “pipestem” fibrosis is appar- ently simple. Heavily infected patients develop periportal fibrosis with vascular obstruction due to the deposition of numerous schistosome eggs along the trajectory of the portal vein.

What is the characteristic liver lesion seen in Schistosoma mansoni infections?

Advanced schistosomal hepatic fibrosis gives a gross appearance of greatly enlarged fibrotic portal tracts, described by Symmers in 1904 as resembling clay pipestems thrust through the liver, and now termed Symmers’ pipestem fibrosis 1 .

What causes hepatomegaly in schistosomiasis?

The historical view of hepatosplenomegaly associated with schistosomiasis is that it is caused by gross periportal fibrosis and resulting portal hypertension.

How does schistosomiasis cause portal hypertension?

The classic form of presinusoidal portal hypertension is caused by the deposition of Schistosoma oocytes in presinusoidal portal venules, with the subsequent development of granulomata and portal fibrosis. Schistosomiasis is the most common noncirrhotic cause of variceal bleeding worldwide.

What is Pipestem fibrosis?

pipe·stem fi·bro·sis a characteristic pipe-shaped fibrosis formed around hepatic portal veins in some cases of long-continued heavy infection with Schistosoma mansoni; thought to be induced by the presence of large numbers of schistosome eggs in the hepatic tissues.

What is Perisinusoidal fibrosis?

Liver fibrosis is characterized by the replacement of liver tissue by extracellular matrix components including collagens. Hepatic stellate cells, also termed perisinusoidal cells, are found in the perisinusoidal space of the liver and are the main matrix-producing cells that drive liver fibrosis.

Does schistosomiasis cause splenomegaly?

Schistosomiasis is a tropical disease. Patients who develop hepatosplenic schistosomiasis have clinical findings including periportal fibrosis, portal hypertension, cytopenia, splenomegaly and gastrointestinal hemorrhage.

How is schistosomiasis diagnosed?

Schistosomiasis is diagnosed through the detection of parasite eggs in stool or urine specimens. Antibodies and/or antigens detected in blood or urine samples are also indications of infection.

How does schistosomiasis cause splenomegaly?

Hepatic schistosomiasis is characterised by deposition of schistosomal eggs in the liver which results in a host cell immune response and leads to granuloma formation and neoangiogenesis. This is hallmarked by different grades of periportal fibrosis with portal hypertension leading to splenomegaly.

What causes urinary schistosomiasis?

Urinary schistosomiasis is caused by S haematobium and deposition of eggs in the bladder and ureters. The subsequent granulomatous inflammation causes nodules, polypoid lesions, and ulcerations in the lumens of the ureter and bladder, which in turn causes urinary frequency, dysuria, and end stream haematuria.

Can schistosomiasis cause pulmonary hypertension?

Schistosoma-associated pulmonary arterial hypertension (SchPAH) is a fatal complication of chronic schistosomiasis infection, and a leading cause of PAH-related morbidity and mortality worldwide (1, 2).

Why is there no ascites in Presinusoidal portal hypertension?

Sinusoidal hypertension appears to be required for fluid retention to occur; presinusoidal portal hypertension, as in portal vein thrombosis, does not result in ascites formation in the absence of another predisposing factor. PHT leads to profound changes in the splanchnic circulation.

What is the pathophysiology of Schistosoma mansoni?

In the latter stages of the disease, the pathology is associated with collagen deposition and fibrosis, resulting in organ damage that may be only partially reversible. (See Pathophysiology, Etiology, and Presentation.) Granuloma in the liver due to Schistosoma mansoni. The S mansoni egg is at the center of the granuloma.

What is the global distribution of schistosomiasis?

According to the World Health Organization (WHO), the global distribution of schistosomiasis has changed in that it has been eradicated from Japan and the Lesser Antilles islands; transmission has been stopped in Tunisia; and transmission is very low in Morocco, Saudi Arabia, Venezuela, and Puerto Rico.

What is the history of schistosomiasis (sail fever)?

[ 3] Sometimes referred to as bilharzias, bilharziasis, or snail fever, schistosomiasis was discovered by Theodore Bilharz, a German surgeon working in Cairo, who first identified the etiological agent Schistosoma hematobium in 1851. [ 6] A Schistosoma egg is seen below.

What are the complications of schistosomiasis (Katayama syndrome)?

Complications of schistosomiasis include the following: Neuroschistosomiasis – Transverse myelitis, paralysis, and cerebral microinfarcts Acute schistosomiasis (Katayama syndrome) is a systemic, serum sickness-like illness that develops after several weeks in some, but not most, individuals with new schistosomal infections.