Diffuse crescentic glomerulonephritis in bacterial endocarditis

Kannan, Sujatha; Mattoo, Tej K.

doi:10.1007/s004670000550

Cited by 41 publications

(47 citation statements)

References 20 publications

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“…in some cases, iE induces rapidly progressive glomerulonephritis and results in end-stage renal failure, which is associated with poor patient prognosis (5). apart from antibiotic therapy, effective strategies include surgery, steroid therapy, immunosuppressive therapy and dialysis (6,7). however, the appropriate therapy for iE associated with renal injury has not been adequately defined.…”

Section: Introductionmentioning

confidence: 99%

Infective endocarditis associated with acute renal failure: Repeat renal biopsy and successful recovery

Wang

Wang²,

Wang³

et al. 2010

Experimental and Therapeutic Medicine

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Abstract. infective endocarditis (iE) is a serious disease with a high associated mortality rate, particularly when complicated by acute renal failure (arF). although valve surgery and treatment with antibiotic agents are recommended, surgical options and the optimal therapy are not as yet well documented. here, we report a rare case of iE in a young man with a history of intravenous drug abuse, who presented with high fever, bilateral thoracalgia, lower limb edema and renal dysfunction. after treatment with antibiotics, hemodialysis and anticoagulants, a tricuspid valve replacement surgery was performed on the patient. after surgery, his renal functions deteriorated and progressed to ARF. The first renal biopsy showed type II crescentic glomerulonephritis. after receiving continuous ambulatory peritoneal dialysis followed by administration of an angiotensin converting enzyme inhibitor and angiotensin receptor blockers, the patient's serum creatinine level decreased and the urine output increased gradually. in order to identify the renal turnover, we performed a second biopsy and found significant improvement in the pathological changes with endocapillary proliferative glomerulonephritis and fibrous crescents. Successful recovery of renal function was achieved 12 weeks after the initiation of therapy. therefore, eradication of infection, tricuspid valve replacement and renal substitution therapy may be sufficient in some cases.

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Section: Introductionmentioning

confidence: 99%

Infective endocarditis associated with acute renal failure: Repeat renal biopsy and successful recovery

Wang

Wang²,

Wang³

et al. 2010

Experimental and Therapeutic Medicine

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“…Tests for syphilis and toxoplasmosis were also negative [17]. As the amniotic fluid was clear, a bacterial infection during pregnancy, resulting in crescentic glomerulonephritis [18,19], seemed to be unlikely in our patient.…”

Section: Discussionmentioning

confidence: 92%

A case of atypical congenital nephrotic syndrome

Świetliński

Maruniak‐Chudek

Niemir

et al. 2004

Pediatric Nephrology

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We present a female newborn with the nephrotic syndrome of intrauterine onset and a unique set of extrarenal abnormalities, as well as atypical renal lesions. The extrarenal anomalies comprised a soft tissue hemangioma in the frontotemporal region, unilateral microphthalmia (with persistent hyperplastic corpus vitreous and detachment of the retina), and glaucoma in the other eye. Immature glomeruli and/or glomeruli with large cellular crescents were found in renal biopsy specimens in the 3rd week of life. On autopsy, 7 weeks later, diffuse mesangial sclerosis (DMS) was the predominant type of glomerular lesion. In addition, dilations of tubules, forming microcysts, as well as clusters of infiltrating cells in the interstitium, were found both in renal biopsy and autopsy specimens. Although the symptoms observed in our patient did not match any reported in association with the known forms of the congenital nephrotic syndrome (CNS), the most probable diagnosis seemed to be CNS due to DMS of intrauterine onset, with superimposed drug-related tubulointerstitial nephritis.

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“…(32,33,34) Recent literature describes cases of anti-cytoplasmic antibody (ANCA) positive endocarditis-associated glomerulonephritis, usually presenting with rapidly progressive renal failure. (35)(36)(37)(38)(39) The typical glomerular lesions are focal proliferative and diffuse proliferative glomerulonephritis associated with increased cellularity in the mesangial and endothelial portion, with or without crescents. (25)(26)(27) Diffuse crescentic glomerulonephritis has also been reported.…”

Section: Glomerulonephritismentioning

confidence: 99%

“…(25)(26)(27) Diffuse crescentic glomerulonephritis has also been reported. (39)(40)(41) Appropriate antibiotic therapy usually results in recovery of renal function. The recovery may be rapid with return to or near baseline in mild cases, though hematuria and proteinuria may persist for months.…”

Section: Glomerulonephritismentioning

confidence: 99%