期刊
CEN CASE REPORTS
卷 10, 期 4, 页码 490-493出版社
SPRINGER JAPAN KK
DOI: 10.1007/s13730-021-00597-8
关键词
Infection; Glomerulonephritis; Nephritis-associated plasmin receptor; Chronic glomerulonephritis
A 27-year-old man presented with heavy proteinuria, hematuria, and acute kidney injury after a fever, diagnosed with infection-related glomerulonephritis with coexisting immunoglobulin A nephropathy. The deposition of nephritis-associated plasmin receptor was identified as a useful marker for worsening urinalysis findings post-bacterial infection in chronic glomerulonephritis.
A 27-year-old man who developed heavy proteinuria with hematuria and acute kidney injury 2 weeks after a fever was referred to our hospital. Because he had low complements without autoantibodies, we clinically diagnosed him with infection-related glomerulonephritis. The proliferation of mesangial cells and endothelial cells with glomerular deposits of immunoglobulin A and complement 3 was found. Deposition of glomerular nephritis-associated plasmin receptor, a marker of infection-related glomerulonephritis, was also found. In addition, the distribution of nephritis-associated plasmin receptor deposition almost perfectly matched the plasmin activity-positive region. Over 3 months later, his symptoms were resolved, although moderate proteinuria and active urine sediment were persistent. He underwent a second renal biopsy, and the histological findings revealed that he had immunoglobulin A nephropathy. Therefore, we diagnosed him with infection-related glomerulonephritis superimposed on immunoglobulin A nephropathy at the first renal biopsy. The glomerular deposition of nephritis-associated plasmin receptor is a useful marker and may cause worsening urinalysis findings after bacterial infection in cases of chronic glomerulonephritis.
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