Myopathic changes in schistosomal hepatosplenomegaly; histopathological, histochemical and immunopathological studies

Eighteen patients suffering mainly from schistosomal hepatosplenomegaly (B.H.S.M.) were selected & classified into 3 groups according to the degree of B.H.S.M. Muscle biopsy for histopathological, histochemical and immunopathological studies were taken. The results showed that fatiguability as a symptom was present in all cases but motor weakness was present in four cases. Twelve cases had peripheral neuropathy in the form of glove and stocking hypothesia, while pyramidal tract lesion was present in four cases. Two cases, however, showed both peripheral neuropathy and pyramidal tract lesions. Histopathological and histochemical assessment revealed frank myopathic changes in 14 cases while only one case showed definite neuropathic changes. The remainder cases were inconclusive. Immunopathological examination revealed marked deposition of IgG in 50% of cases, while IgM and IgA showed mild to moderate reactions. It was concluded that muscular changes in schistosomal patients are myopathic in nature and that immunological mechanisms could be considered as a factor in the pathogenesis of this muscular disorder.