Circadian variation of ova excretion, proteinuria, hematuria, and leukocyturia in urinary schistosomiasis

Abstract

Urine samples from five boys (7 to 9 years) with urinary schistosomiasis were collected at 6 A.M. and thereafter at 3-hr intervals until 9 P.M. on 5 consecutive days. Ova excretion in the urine, proteinuria (PU), erythrocyturia (EU), and leucocyturia (LU) were assessed quantitatively. Egg excretion followed a circadian rhythm with a peak at 12 noon and was paralleled closely by pathological PU. Maximal erythrocyturia occurred at 6 P.M., whereas leucocyturia revealed two distinct peak times. Taking the congruent patterns of egg excretion and PU together with the results of qualitative urinary protein analysis into account, it was concluded that PU was linked causally to ova excretion and could be explained by bleeding and exudation of serum proteins during penetration of ova through the bladder mucosa. In contrast, EU and LU seemed to be caused by different pathological mechanisms. EU followed a time-delayed circadian rhythm, possibly induced by persistent bleeding, whereas LU may have indicated a concomitant inflammatory component of the bladder.