Occasionally a patient with schistosomiasis may develop pulmonary hypertension. Early therapy can prevent disease progression.


Usual species associated with pulmonary hypertension:

(1) S. mansoni

(2) S. japonicum


Risk factors for pulmonary hypertension:

(1) chronic, heavy schistosomal infection

(2) portocaval shunt or other collateral circulation that allows eggs to embolize to the lungs


Clinical features:

(1) fatigue

(2) cough with or without hemoptysis

(3) dyspnea on exertion

(4) elevated pulmonary artery pressure

(5) peripheral edema and other signs of right heart failure

(6) right ventricular hypertrophy with strain, eventually resulting in cor pulmonale


A lung biopsy may show:

(1) granulomatous pulmonary arteritis

(2) fibrointimal sclerosis in small arteries and arterioles

(3) fibrinoid necrosis and angiomatoid formation


The diagnosis requires exclusion of other causes of pulmonary artery hypertension.


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