Nephrotic syndrome in a mother and her infant: relationship with cytomegalovirus infection

Abstract

This case report describes infantile nephrotic syndrome (NS) in a baby girl with a clinically severe cytomegalovirus (CMV) infection. Culture of the baby's urine was positive for CMV and IgM anti-CMV antibodies were detected. After an unsuccessful course of corticosteroids, gancyclovir treatment was started and a remission of cutaneous, pulmonary, and renal symptoms was achieved. As the mother also developed NS at the end of pregnancy, a common etiology could be postulated, although there were no signs of recent CMV infection in the mother, only anti-CMV IgG. The relationship between CMV infection and glomerular disease is still unclear; NS may represent another manifestation of CMV disease.

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-related congenital nephrotic syndrome with diffuse mesangial sclerosis

“…Giani et al treated a 5-month-old girl with CMV infection, who developed signs of multisystemic disease and nephrotic syndrome. Ganciclovir administration led to improved parameters, including proteinuria, but the diagnosis was not confirmed by renal biopsy [2]. Evans and Lyon reported a fatal congenital CMV infection that caused nephrotic syndrome.…”

“…However, the causal relationship between CMV infection and NS is still unclear. There are still few reports documenting that such an association exists [1][2][3][4]. More recently, Frishberg et al reported a case of mutated podocin manifesting as CMV-associated CNS and proposed that CMV infection is only a secondary finding [5].…”

Nephrotic syndrome in the first year of life

“…Prednisolone treatment results in complete recovery. CNS is rarely associated with CMV [13] and Rubella and a causal role remains doubtful. In our study, 2 (6.6%) had CMV infection and remitted with Ganciclovir.…”