Relationship between schistosomiasis and arthropathy

This study was carried out to suggest criteria for diagnosing arthritis associated with schistosomiasis. 180 cases were classified into three clinical groups, 120 schistosomal arthritic group (I), 20 schistosomal non-arthritic (II), 20 arthritic non-schistosomal (III) and 20 controls (IV). Four tests were done to exclude other causes of arthritis namely, Erythrocyte sedimentation rate (ESR), Rose-Waaler test (RW) for rheumatoid factor (RF), antinuclear antibody test (ANA) and determination of serum uric acid (SUA) level. A history, clinical examination, urine and stool examination, intradermal test (IDT), indirect haemagglutination test (IHAT), circumoval precipitin test (COPT) and complete blood picture, were performed for all groups. 20 patients were selected randomly from group I and received praziquantel to be followed up 6 months later. Bilharzial ova were found in the excreta of group I and II. The percentage of positive IDT, IHAT and COPT in I & II was 90.8%, 90%, 88.3% and 85% respectively. Blood picture showed mild anaemia and from low to moderate eosinophilia. ESR was moderately raised. RF positivity was 6.6%, 10%, 65% and 5% in the four groups respectively. ANA positivity was 1.6%, 0%, 50% and 0% respectively. There was a marked improvement of arthritic manifestations after praziquantel in 90% of cases.