Clinical Characteristics and Etiologic Analysis of Scabies-Associated Glomerulonephritis

Abstract

Objective: Scabies-associated glomerulonephritis (SGN) is often seen in certain populations, but little is known about its incidence, clinical characteristics, prognosis and pathogenesis. Methodology: 376 patients with scabies were enrolled and divided into scabies-alone group (group A) and SGN group (group B) based on the presence or absence of glomerulonephritis. Clinical indicators and various biomarkers, including serum C-reactive protein, complement components C3 and C4, immunoglobulin, TNF-α, IL-6, IL-1β, and IL-18 in the early stage of the disease, were determined before and after treatment. All patients were follow-up in the clinic. Results: 16 scabies patients developed SGN in this study. The clinical manifestations included glomerular hematuria and/or mild-moderate proteinuria. The manifestations associated with kidney injury in most of these patients completely resolved 2-6 months after scabies was cured. Compared to the patients in group A, the levels of serum CRP, IgG, TNF-α, IL-6, and IL-18 increased significantly and the serum C3 level decreased significantly in the patients in group B. Twelve patients with SGN achieved a clinical cure. Compared to the early stage of the disease, the levels of serum IgG, hs-CRP, TNF-α, IL-6, and IL-18 in these patients decreased significantly after being cured, and the serum C3 level increased significantly. Conclusions: SGN is generally mild and has a good prognosis. The mechanisms may involve the generation of specific antibodies stimulated by itch mites, triggering of excessive immune and inflammatory responses.

Scabies in the Amhara region of northern Ethiopia: a cross-sectional study of prevalence, determinants, clinical presentation and community knowledge

“…Presentation can also include pustules, nodules, chronic excoriation and skin crust 9. Though itch and sleep deprivation are the primary complications of scabies, secondary bacterial infections are associated with cellulitis, fasciitis, septicaemia, acute glomerulonephritis and rheumatic heart disease 6 10 11. Clinical diagnosis is the most frequently used approach in clinical and field settings, though accuracy relies heavily on examiners’ knowledge and experience of scabies 12…”