Pathogenesis of Hepato-splenic Manifestation of Schistosoma
Infection
Penetration of intact skin withinfective cercariae
Ova in the portal blood
Ova lodge at the presinusoidal sites
Hepatomegaly
Presinusoidal portal blockage
Hemodynamic changes
GRANULOMA formationGRANULOMA formation
Recruitment of host’s inflammatory cells SplenomegalyPortosystemic collaterals
HLA Type I & II
genetics
Varices at the lower end of esophagus and
other sites
Portal hypertension
Compensatory arterialization
Retention of hepatocyte perfusion
N liver function tests
FIBROSISFIBROSIS
T-lymphocytes - fibroblast series interaction
cytokines (IL-2, IL-4, IL-1, TGF-B)
>>>IFN-γ, IL-12
Liver function deteriorationAscites, hypoalbuminemia
defects in coagulation
Periportal(Symmers’ clay pipe-stem fibrosis)Diffuse
CIRRHOSIS