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Hepatic Schistosomiasis — SCE Infectious Diseases MCQ

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HardParasitologyHepatic SchistosomiasisSCE Infectious Diseases

A patient with intestinal Schistosoma mansoni infection develops splenomegaly, oesophageal varices and preserved albumin and INR. Which hepatic lesion explains this pattern?

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Correct answer: C — Presinusoidal periportal fibrosis with preserved hepatocyte function

The best answer is “Presinusoidal periportal fibrosis with preserved hepatocyte function”. Egg-driven granulomatous inflammation produces Symmers pipe-stem periportal fibrosis, so portal pressure can be severe while synthetic function is relatively preserved. Chronic intestinal schistosomiasis can cause presinusoidal periportal fibrosis and portal hypertension while hepatocellular synthetic function remains relatively preserved.

Reference: WHO schistosomiasis fact sheet: https://www.who.int/news-room/fact-sheets/detail/schistosomiasis