Retroperitoneal fibrosis associated with schistosoma japonicum infestation--an immunologically mediated disease?

A patient with S. japonicum infestation of the liver presented with acute renal failure due to retroperitoneal fibrosis, together with the presence of low complement levels, anti-nuclear and anti-DNA antibodies. Renal failure responded to intravenous bolus methylprednisone and later definitive surgery, with complement levels returning to normal after the acute episode. The findings are consistent with the hypothesis that retroperitoneal fibrosis may be a local manifestation of a systemic immune disease, in which the associated S. japonicum infestation may have a role.