| An adult with acute poststreptococcal glomerulonephritis complicated by hemolytic uremic syndrome and nephrotic syndrome. | |
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MedLine Citation:
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PMID: 16183409 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We report the case of a 47-year-old man with the simultaneous occurrence of clinical and laboratory features consistent with acute poststreptococcal glomerulonephritis (APSGN), hemolytic uremic syndrome (HUS), and nephrotic syndrome. Acute nephritic syndrome occurred 3 weeks after having pharyngeal pain and diarrhea. He presented with edema and hypertension on admission. Laboratory evaluation showed hemolytic anemia with fragmentation, thrombocytopenia, elevated lactic dehydrogenase level, low haptoglobin level, low complement C3 level, and elevated antistreptolysin-O titer. Serum creatinine level was 1.22 mg/dL (108 micromol/L), and urinalysis showed marked proteinuria, with protein of 8.7 g/d, and hematuria. The renal biopsy specimen was characteristic of APSGN, but not HUS. Moderate expansion of the mesangial matrix, moderate proliferation of epithelial and endothelial cells, and marked infiltration of neutrophils was seen by means of light microscopy, and many subepithelial humps were seen by means of electron microscopy. Neither fibrin deposition nor evidence of thrombotic microangiopathy was found. Complement C3 deposition along the capillary wall and tubules was seen in an immunofluorescence study. The patient was administered plasma infusion at 320 mL/d and antihypertensive drugs. Serum complement C3 and haptoglobin levels returned to normal within 3 weeks. This is a rare case of the simultaneous occurrence of APSGN, HUS, and nephrotic syndrome. |
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Authors:
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Tomoko Izumi; Toshitake Hyodo; Yuichi Kikuchi; Toshihiko Imakiire; Tatsuyoshi Ikenoue; Shigenobu Suzuki; Nobuyuki Yoshizawa; Soichiro Miura |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: American journal of kidney diseases : the official journal of the National Kidney Foundation Volume: 46 ISSN: 1523-6838 ISO Abbreviation: Am. J. Kidney Dis. Publication Date: 2005 Oct |
Date Detail:
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Created Date: 2005-09-26 Completed Date: 2005-11-03 Revised Date: 2007-12-05 |
Medline Journal Info:
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Nlm Unique ID: 8110075 Medline TA: Am J Kidney Dis Country: United States |
Other Details:
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Languages: eng Pagination: e59-63 Citation Subset: IM |
Affiliation:
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Second Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Antibodies, Bacterial / blood, immunology Antigens, Bacterial / immunology Antigens, Tumor-Associated, Carbohydrate / immunology Autoantigens / immunology Bacterial Proteins / immunology, physiology Complement C3 / analysis, deficiency Creatinine / blood Glomerulonephritis / etiology*, pathology Hemolytic-Uremic Syndrome / etiology* Humans Male Microscopy, Fluorescence Middle Aged Nephrotic Syndrome / etiology*, pathology Neuraminidase / physiology Neutrophils / pathology Proteinuria / etiology Streptococcal Infections / complications*, microbiology Streptococcus pyogenes / immunology, isolation & purification* Streptolysins / immunology |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Bacterial; 0/Antigens, Bacterial; 0/Antigens, Tumor-Associated, Carbohydrate; 0/Autoantigens; 0/Bacterial Proteins; 0/Complement C3; 0/Streptolysins; 0/streptolysin O; 3554-90-3/Thomsen-Friedenreich antigen; 60-27-5/Creatinine; EC 3.2.1.18/Neuraminidase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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