{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T02:55:38Z","timestamp":1783997738205,"version":"3.55.0"},"reference-count":22,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T00:00:00Z","timestamp":1668643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"French Government"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Background. Schistosomiasis is an endemic parasitic infection found in many tropical countries and is highly prevalent in sub-Saharan Africa. It can follow different and atypical clinical patterns. In these unusual cases, diagnosis may be difficult, as symptoms are unspecific. Arthropathy can appear in parasitic infections, but making a connection between arthritis and parasitic aetiology is difficult. This review aims to summarise all cases that have reported schistosomiasis associated with arthropathy, and the different ways authors have diagnosed this disease. Method. We present a systematic literature review of schistosomiasis associated with joint impairments, with a focus on the difficulty of differentiating between reactive arthritis and its parasitic presence in situ. Results. Joint impairments mimicking polyarthropathy are not rare in parasitic infections. Diagnosis is difficult. On the one hand, some patients have arthritis with parasite eggs found in situ, particularly in synovial biopsy. These situations are less common and antiparasitic treatment is straightforward. On the other hand, arthritis can be associated with parasitic infections in the form of reactive arthritis due to an immunological reaction. In such cases, pathogenicity due to circulating immune complex should be suspected. Anti-inflammatory treatments such as corticosteroids or immunosuppressive therapies are ineffective in cases of schistosomal arthropathy. A joint fluid puncture appears to be necessary and parasitic examination as well as in situ immunological techniques appear to be important in order to confirm the diagnosis of schistosomal arthropathy. Conclusions. The frequency of articular schistosomiasis is probably underestimated and should be sought when patients have unexplained polyarthropathy, as it can be an alternative diagnosis when patients have concomitant parasitic infections. These situations are common, whereas the association between unexplained inflammatory arthritis and a concomitant parasitic infection is rarely made. Unspecific rheumatism can lead to probabilistic treatments with many side effects, and looking for a parasitic aetiology could lead to repeated antiparasitic treatments and may avoid other immunosuppressive or corticosteroid therapies. With increasing travel and global migration, physicians need to be more aware of nonspecific symptoms that may reveal an atypical presentation of a tropical disease that can be treated easily, thus avoiding inappropriate immunosuppressive treatments.<\/jats:p>","DOI":"10.3390\/pathogens11111369","type":"journal-article","created":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T03:05:21Z","timestamp":1668654321000},"page":"1369","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Schistosomiasis and Recurrent Arthritis: A Systematic Review of the Literature"],"prefix":"10.3390","volume":"11","author":[{"given":"Coline","family":"Mortier","sequence":"first","affiliation":[{"name":"IHU-M\u00e9diterran\u00e9e Infection, Assistance Publique H\u00f4pitaux de Marseille (AP-HM), 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u00efssane","family":"Mehadji","sequence":"additional","affiliation":[{"name":"IHU-M\u00e9diterran\u00e9e Infection, Assistance Publique H\u00f4pitaux de Marseille (AP-HM), 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Amrane","sequence":"additional","affiliation":[{"name":"IHU-M\u00e9diterran\u00e9e Infection, Assistance Publique H\u00f4pitaux de Marseille (AP-HM), 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Laurence","family":"Demoux","sequence":"additional","affiliation":[{"name":"Assistance Publique H\u00f4pitaux de Marseille, Service de m\u00e9decine interne, H\u00f4pital Nord, 13015 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1086-3745","authenticated-orcid":false,"given":"Coralie","family":"L\u2019Ollivier","sequence":"additional","affiliation":[{"name":"IHU-M\u00e9diterran\u00e9e Infection, Assistance Publique H\u00f4pitaux de Marseille (AP-HM), 13005 Marseille, France"},{"name":"Aix Marseille University, IRD, AP-HM, SSA, VITROME, IHU M\u00e9diterran\u00e9e, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,17]]},"reference":[{"key":"ref_1","first-page":"108","article-title":"Schistosomial arthritis","volume":"22","author":"Girges","year":"1966","journal-title":"Rheumatism"},{"key":"ref_2","first-page":"602","article-title":"Urinary schistosomiasis and articular manifestations","volume":"40","author":"May","year":"1973","journal-title":"Rev. Rhum. Mal. Osteo-Articul."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1136\/ard.43.6.806","article-title":"Bilharzial arthropathy","volume":"43","author":"Bassiouni","year":"1984","journal-title":"Ann. Rheum. Dis."},{"key":"ref_4","first-page":"479","article-title":"Schistosomiasis and Inflammatory Polyarthritis: A Clinical, Radiological and Laboratory Study of 96 Patients Infected by S. mansoni with Particular Reference to the Diarthrodial Joint","volume":"59","author":"Atkin","year":"1986","journal-title":"QJM Int. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1002\/art.1780290220","article-title":"Immune complex arthritis in a patient with Schistosoma mansoni infection","volume":"29","author":"Greenfield","year":"1986","journal-title":"Arthritis Rheum."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1302\/0301-620X.75B4.8331116","article-title":"Synovial schistosomiasis of the hip","volume":"75-B","author":"Fachartz","year":"1993","journal-title":"J. Bone Jt. Surg. Br. Vol."},{"key":"ref_7","first-page":"597","article-title":"Schistosomial arthritis. A case-report","volume":"65","author":"Rolland","year":"1998","journal-title":"Rev Rhum Engl Ed."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1007\/s00296-010-1562-7","article-title":"Schistosoma mansoni infection: An immune complex disease presenting with polyarthritis","volume":"33","author":"Lapa","year":"2013","journal-title":"Rheumatol Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"229","DOI":"10.5152\/eurjrheum.2017.16084","article-title":"Bilharzial arthropathy: Rare cause of chronic arthritis in tropical areas","volume":"4","author":"Rakotomalala","year":"2017","journal-title":"Eur J Rheumatol."},{"key":"ref_10","first-page":"200","article-title":"Presentation of polyarthritis in patients with Schistosoma Mansoni","volume":"15","author":"Saldarriaga","year":"2013","journal-title":"Rev. Cub. Reu."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"207","DOI":"10.7326\/0003-4819-94-2-207","article-title":"Reactive Arthritis Induced by Parasitic Infestation","volume":"94","author":"Bocanegra","year":"1981","journal-title":"Ann. Intern. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1136\/bmj.2.5969.476","article-title":"Circulating immune complexes in schistosomiasis due to Schistosoma mansoni","volume":"2","author":"Phillips","year":"1975","journal-title":"BMJ"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"148","DOI":"10.7326\/0003-4819-83-2-148","article-title":"Immune Complex Nephropathy in Schistosomiasis","volume":"83","year":"1975","journal-title":"Ann. Intern. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1136\/bmj.1.5955.435","article-title":"Circulating soluble antigens and antibody in schistosomiasis","volume":"1","author":"Madwar","year":"1975","journal-title":"BMJ"},{"key":"ref_15","first-page":"51","article-title":"Circulating immune complex in bilharzial arthropathy","volume":"22","author":"Bebars","year":"1992","journal-title":"J. Egypt. Soc. Parasitol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Cnops, L., Soentjens, P., Clerinx, J., and Van Esbroeck, M. (2013). A Schistosoma haematobium-Specific Real-Time PCR for Diagnosis of Urogenital Schistosomiasis in Serum Samples of International Travelers and Migrants. PLoS Negl. Trop. Dis., 7.","DOI":"10.1371\/journal.pntd.0002413"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1159\/000301976","article-title":"Antik\u00f6rper im Kammerwasser","volume":"127","author":"Goldmann","year":"1954","journal-title":"Ophthalmologica"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.ajo.2005.09.017","article-title":"Polymerase Chain Reaction and Goldmann-Witmer Coefficient Analysis Are Complimentary for the Diagnosis of Infectious Uveitis","volume":"141","author":"Rothova","year":"2006","journal-title":"Am. J. Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1136\/bjophthalmol-2017-311528","article-title":"Comparison of immunoblotting (IgA and IgG) and the Goldmann-Witmer coefficient for diagnosis of ocular toxoplasmosis in immunocompetent patients","volume":"102","author":"Mathis","year":"2018","journal-title":"Br. J. Ophthalmol."},{"key":"ref_20","first-page":"13","article-title":"Les rhumatismes parasitaires","volume":"88","author":"Doury","year":"2000","journal-title":"Synoviale"},{"key":"ref_21","first-page":"146","article-title":"Manifestations articulaires des parasitoses","volume":"2","author":"Boissier","year":"2005","journal-title":"EMC\u2014Mal. Infect."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1302\/0301-620X.75B4.8331101","article-title":"Schistosomiasis","volume":"75-B","author":"Bear","year":"1993","journal-title":"J. Bone Jt. Surg. Br. Vol."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/11\/11\/1369\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:19:50Z","timestamp":1760145590000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/11\/11\/1369"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,17]]},"references-count":22,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["pathogens11111369"],"URL":"https:\/\/doi.org\/10.3390\/pathogens11111369","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,17]]}}}