Scintigraphic findings in schistosomiasis.

Schistosomiasis mansoni is a tropical parasitic disease caused by a blood fluke which inhabits the portal system of humans. Fifteen pediatric patients with the acute disease were evaluated with liver and spleen scintigraphy (LSS). Clinical history, physical examination, and serum chemistries failed to reveal any other underlying systemic disease. Liver and spleen scintigraphies were performed before therapy, 7 months and 9 years after therapy with oxamniquine. LSS initially showed hepatomegaly in 93% of the patients. In the first follow up study a reactive spleen was evident in 78% of the cases, with an unchanged hepatic image. Long term follow up revealed that from the initially enlarged livers, 93% became normal. However, 47% of the spleens were abnormal. The scintigraphic changes observed in the liver over the years were those expected for an acute infection. The findings in the spleen might indicate the persistence of an immunologic reaction with a continuous trigger, probably an antibody. These observations suggest that the LSS can be used in the evaluation and follow-up of these patients.