Cytomegalovirus-related congenital nephrotic syndrome with diffuse mesangial sclerosis

Abstract

This case report describes congenital nephrotic syndrome in a 2-month-old girl associated with cytomegalovirus infection. Histological examination on renal biopsy showed diffuse mesangial sclerosis and cytomegalic inclusion bodies in the tubular cells and in some glomeruli. Cytomegalovirus (CMV) polymerase chain reaction (PCR) titer in serum was high. Remission of pulmonary and renal symptoms was achieved with ganciclovir in 3 weeks. No recurrence of proteinuria was observed during the follow-up period of 14 months. These finding suggested a causal relationship between congenital nephrotic syndrome and cytomegalovirus infection.

Membranous nephritis associated with acquired cytomegalovirus infection in a 19-month-old baby

“…Although not all of the cases published are well documented, they are described as being congenital nephrotic syndrome. All of the reported cases were treated with ganciclovir, which was discontinued in one patient due to its side effects [19][20][21]. There are also two reports of pediatric patients, a 3-month old baby and a 14-year-old boy, with interstitial nephritis associated with CMV infection [22,23].…”

Cytomegalovirus infection and haemophagocytosis in a patient with congenital nephrotic syndrome

“…Frishberg et al [4] reported a case of mutated podocin manifesting as CMV-associated CNS and proposed that CMV infection was only a secondary finding. Recently, Besbas et al [5] reported a 2-month-old girl with CMVassociated CNS and diffuse mesangial sclerosis in her renal biopsy. Her proteinuria disappeared and her clinical status improved after ganciclovir treatment.…”

“…However, the causal relationship between CMV infection and CNS has still not been unfolded. There are still few reports documenting that such an association exists [4,5]. Frishberg et al [4] reported a case of mutated podocin manifesting as CMV-associated CNS and proposed that CMV infection was only a secondary finding.…”

Immunodysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome: an unusual cause of proteinuria in infancy

“…Proteinuria in infancy is rare and may occur due to congenital nephrotic syndrome, diffuse mesangial sclerosis, Denys-Drash syndrome, congenital infections, such as cytomegalovirus (CMV), Epstein-Barr virus (EBV) and syphilis, and other uncommon disorders such as GallowayMowat syndrome and rare disorders of the glomerular basement membrane [1][2][3][4][5]. Rarely, idiopathic minimal change and focal segmental glomerulosclerosis cause nephrotic syndrome in late infancy [6].…”