Acute renal failure presenting as a granulomatous interstitial nephritis due to cryptococcal infection

Chung, Sungjin; Park, Cheol W.; Chung, Hyun Wha; Chang, Yoon Sik

doi:10.1038/ki.2008.494

Cited by 11 publications

(7 citation statements)

References 45 publications

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“…Information in the literature documenting the frequency of renal involvement in cryptococcal infection is limited to autopsy reports and few case reports. 16,17 The renal failure in our patient was likely multifactorial and due to the acute and evolving thrombotic microangiopathy secondary to the presence of GvHD, tacrolimus exposure and possibly the presence of cryptoccocal infection as reported in a few case reports leading to disseminated intravascular coagulation. [18][19][20] In addition, there is increasing evidence that endothelial injury in the kidney may be secondary to circulating inflammatory cytokines related to GvHD elsewhere in the body.…”

Section: Discussionmentioning

confidence: 63%

Disseminated cryptococcal infection in allogeneic stem cell transplant patients: a rare cause of acute kidney injury

Oliver

Luong²,

Tchakarov³

et al. 2016

Bone Marrow Transplant

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Hematopoietic stem cell transplantation (HSCT) can be lifesaving for some of the deadliest hematologic diseases. However, immunosuppression, polypharmacy and risk of infectious complications associated with HSCT can increase morbidity and mortality for recipients. Incidence of acute kidney injury (AKI) after HSCT can be as high as 70%, and concomitant infection can be a therapeutic challenge for oncologists, nephrologists and infectious disease specialists. We illustrate this challenge in the case of a 31-year-old man with acute lymphoblastic leukemia who underwent a double cord HSCT complicated by GvHD, systemic cryptococcal and BK virus infections and AKI. Kidney biopsy showed round to cup-shaped organisms with occasional budding, consistent with Cryptococcus and thrombotic microangiopathy. We discuss our findings and a literature review of disseminated cryptococcal infection with renal involvement after HSCT.

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Section: Discussionmentioning

confidence: 63%

Disseminated cryptococcal infection in allogeneic stem cell transplant patients: a rare cause of acute kidney injury

Oliver

Luong²,

Tchakarov³

et al. 2016

Bone Marrow Transplant

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“…Renal involvements of C. neoformans were pathologically described previously [20]. However pathologic lesions of genitourinary tract has rarely been reported in patients having crypto- …”

Section: Discussionmentioning

confidence: 92%

Two Cases of Cryptococcuria Developed as Isolated Cryptococcuria and Disseminated Cryptococcosis

Bae

Namgoong

et al. 2011

Korean J Clin Microbiol

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Cryptococcus is an opportunistic pathogen that mainly affects immunocompromised hosts and, less frequently, immunocompetent hosts. It causes serious morbidity and mortality due to systemic infections such as meningoencephalitis and pulmonary infection. Urinary involvement of Cryptococcus is sometimes reported among cases of disseminated cryptococcosis in AIDS patients, but no such reports have been published in Korea. We report two cases of cryptococcuria that developed in a 71-year old female with diabetes and liver cirrhosis and in a 50-year old male who received a liver transplant due to HBV-associated hepatic failure. The female patient had received prednisolone for 12 days before we detected C. neoformans in urine culture. Even though no antifungal therapy was indicated for cryptococcuria, following urine culture became negative, but still positive for cryptococcal antigen on hospital day 25. Her blood, CSF culture, and antigen tests were negative, and therefore she was diagnosed with isolated cryptococcuria. The male patient had received prednisolone and tacrolimus for 10 days before sputum and urine cultures became positive for C. neoformans. He had ill defined nodules and pleural effusion in both lungs on chest CT. His cryptococcuria was sustained for over 2 months, despite receiving amphotericin B treatment. His cryptococcuria seemed to be a symptom of disseminated cryptococcosis. (Korean J Clin Microbiol 2011;14:148-152)

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“…Similar presentation of GIN has so far been reported in only one other patient [ 4 ] and there is no possible explanation for the nephrotic proteinuria seen in these patients. Such presentations may be seen with Non-Steroidal Anti-Inflammatory Drug-induced acute interstitial nephritis but in our case, detailed evaluation for other causes of GIN like drugs, infections and systemic conditions like sarcoidosis, Wegener’s granulomatosis revealed negative results [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Rapidly progressive renal failure--a rare presentation of granulomatous interstitial nephritis due to tuberculosis--case report and review of literature

Kaul

Sharma

Krishnasamy

et al. 2011

Clinical Kidney Journal

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Granulomatous interstitial nephritis (GIN) is a rare manifestation of renal tuberculosis (TB). We report a case of rapidly progressive renal failure (RPRF), granulomatous inflammation of cervical lymph node and GIN as presenting manifestations of TB. Aspiration cytology of cervical lymph node showed granulomatous necrotizing inflammation with acid-fast bacilli (AFB). The renal biopsy and urine specimen did not show AFB. Urine polymerase chain reaction (PCR) for Mycobacterium tuberculosis was positive. We observe that GIN due to TB can present as RPRF and emphasize the value of PCR-based techniques in making a correct diagnosis.

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Acute renal failure presenting as a granulomatous interstitial nephritis due to cryptococcal infection

Cited by 11 publications

References 45 publications

Disseminated cryptococcal infection in allogeneic stem cell transplant patients: a rare cause of acute kidney injury

Disseminated cryptococcal infection in allogeneic stem cell transplant patients: a rare cause of acute kidney injury

Two Cases of Cryptococcuria Developed as Isolated Cryptococcuria and Disseminated Cryptococcosis

Rapidly progressive renal failure--a rare presentation of granulomatous interstitial nephritis due to tuberculosis--case report and review of literature

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