Background
Case presentation
Complete blood count and blood chemistry | Value |
---|---|
WBC | 13,600/μL |
Bands | 2% |
Segments | 82% |
Eosinophils | 0% |
Basophils | 0% |
Lymphocytes | 7% |
Monocytes | 8% |
RBC | 323 × 104/μL |
Hemoglobin | 7.6 g/dL |
Hematocrit | 29.2% |
Platelet | 12.0 × 104/μL |
Total protein | 7.0 g/dL |
Albumin | 2.6 g/dL |
AST | 35 IU/L |
ALT | 23 IU/L |
CRP | 7.57 mg/dL |
Na+ | 130 mmol/L |
K+ | 5.3 mmol/L |
Cl− | 101 mmol/L |
Ca2+ | 7.7 mg/dL |
Phosphate | 3.8 mg/dL |
BUN | 25 mg/dL |
Cr | 2.52 mg/dL |
eGFR | 20.8 ml/minute/1.73 m2 |
Uric acid | 6.3 mg/dL |
HbA1c | 6.3% |
Glucose | 106 mg/dL |
ASO | 73 IU/mL |
Hepatitis B antigen | < 0.04 |
Hepatitis C antibody | < 0.29 |
IgG | 2692 mg/dL |
IgA | 340 mg/dL |
IgM | 350 mg/dL |
Anti-DNA antibody | < 10 |
Anti-RNP antibody | Negative |
Anti-Sm antibody | Negative |
C3 | 50 mg/dL |
C4 | 17 mg/dL |
CH50 | 23.4 U/mL |
Antinuclear antibody | 160 |
PR3-ANCA | 163 IU/mL |
MPO-ANCA | < 1.0 IU/mL |
Anti-GBM antibody | < 2.0 IU/mL |
ESR | 86 mm/hour |
Rheumatoid factor | 86 IU/mL |
Urinary analysis | |
RBC | Numerous (dysmorphic)/HPF |
WBC | 1–4/HPF |
Protein | 0.74 g/g Cr |
β2-MG | 12,133 μg/L |
Discussion and conclusions
Age (years)/sex | Renal biopsy histology (IF/EM) | PR3-ANCA (IU/mL) | Microbe detected | Past medical history | Treatments | Outcome | Reference |
---|---|---|---|---|---|---|---|
54/M | Focal necrotizing crescentic GN (negative/no deposits) | 2.96 | Streptococcus mutans | MVP | Piperacillin, tazobactam, cyclophosphamide, corticosteroids | Complete recovery | [10] |
59/M | Focal necrotizing crescentic GN (negative/no deposits) | > 8.0 | Enterococcus faecalis | Hepatitis B and C | Pulse methylprednisolone ⇒ prednisolone | Hemodialysis | [11] |
67/M | Focal necrotizing crescentic GN (IgA+, IgM+, IgG+, C3+, C1q+/mesangial and subendothelial dense deposits) | 85 | Gemella sanguinis | No mention | Ceftriaxone, gentamicin, methylprednisolone | Temporary hemodialysis ⇒ complete recovery | [12] |
6/M | Crescentic GN (no mention) | Positive | Bartonella henselae | CHD | Doxycycline, rifampicin | No mention | [13] |
12/F | Crescentic GN (C3+/subendothelial dense deposits) | Positive | Gemella morbillorum | Nothing | Penicillin, gentamicin, steroids | Complete recovery | [14] |
14/M | Crescentic GN (no mention) | Positive | Bartonella henselae | CHD | Doxycycline | No mention | [13] |
18/F | Crescentic GN (IgG[1+], IgM[3+], C3[2+], C1q[2+]/subendothelial dense deposits) | 32 | Bartonella henselae | Tetralogy of Fallot, SSS, and complete heart block | Antibiotic therapy, methylprednisolone | Complete recovery | [15] |
24/M | Crescentic GN (C3+/mesangial and subendothelial dense deposits) | 14 | α-Hemolytic Streptococcus | VSD | Cefotaxime, prednisolone | No renal dysfunction | [16] |
26/F | Crescentic GN (IgM+ C3+/no mention) | 160 | Streptococcus viridans | ASD, recent dental Tx | Penicillin G, tobramycin | Recovery | [17] |
36/M | Crescentic GN (negative/no mention) | 359 | Bartonella henselae | No mention | Prednisolone, intravenous cyclophosphamide ⇒ azathioprine, MMF, prednisolone, CV surgery | Complete recovery | [18] |
43/M | Crescentic GN (negative/no mention) | Positive | Bartonella henselae | Infective endocarditis (blood culture was negative) | Cyclophosphamide, prednisoloneCV surgery | No mention | [19] |
46/M | Crescentic GN (C3+ C1q+/no mention) | 25 | Negative | No mention | Amoxicillin, gentamicin, penicillin | Complete recovery | [20] |
47/M | Crescentic GN (IgM+, IgA+, C3+, C1q+/mesangial and subendothelial dense deposits) | 160 | Bartonella henselae | Cat scratch disease | Doxycycline, rifampicin 6 weeks | Recovery | [21] |
50/M | Crescentic GN (negative/not performed) | 247 | Streptococcus oralis | Nothing | Steroid therapy ⇒ ampicillin, gentamicin, vancomycin | Death | [22] |
54/M | Crescentic GN (IgM+, C3+/no deposits) | 3 | Streptococcus mutans | No mention | Ampicillin ⇒ vancomycin, corticosteroids, cyclophosphamide | Recovery | [23] |
55/M | Crescentic GN (C3[2+], IgA+/no deposits) | > 8.0 | Bartonella henselae, Bartonella quintana | Depression | Vancomycin, cefepime ⇒ doxycycline, rifampicin, methylprednisolone | Recovery | [24] |
67/M | Crescentic GN (IgM+, C3+, C1q+/no mention) | 41 | Bartonella henselae | Thoracic aortic aneurysm repair | Rifampicin, doxycycline, methylprednisolone | Temporary hemodialysis ⇒ recovery | [25] |
72/F | Crescentic GN (no mention) | Positive | Aggregatibacter aphrophilus | No mention | Vancomycin, ceftriaxone | Temporary hemodialysis ⇒ recovery | [26] |
42/M | Diffuse endocapillary proliferative GN (C3+/subendothelial dense deposits) | 21.3 | Staphylococcus aureus | Nothing | Cefazolin | Recovery | [27] |
68/M | Diffuse endocapillary proliferative GN and crescentic GN (IgG[2+], IgM[3+], C3[3+], C1q[2+]/subendothelial dense deposits) | 102 | Negative | Schistosomiasis | Cefoperazone, tazobactam | Complete recovery | [28] |
78/F | Endocapillary proliferative GN (IgM+, C3+, C1q+/no mention) | 30 | Bartonella henselae | Hypertension | Doxycycline | Complete recovery | [29] |
48/M | Mesangial proliferative GN (C3+/no mention) | 12 | Negative | Alcoholism, DM | Amoxicillin, gentamicin | Complete recovery | [20] |
57/M | Mesangial proliferative GN (IgG+, IgM+, C3+ /no mention) | 45 | Negative | Nothing | Corticosteroids ⇒ ampicillin, ceftriaxone, gentamicin, vancomycin | Recovery | [30] |
74/M | Mesangial proliferative GN (IgG+, C1q+/not performed) | > 100 | Bartonella henselae, Bartonella quintana | IHD, pacemaker, DM, pulmonary embolus | Antibiotic therapy | Recovery | [31] |
78/M | Mesangial proliferative GN (IgM+, C3+, IgA+, C1q+/subendothelial dense deposits) | 143 | Enterococcus faecalis | Coronary artery bypass surgery | Antibiotic therapy | Death | [32] |
57/M | FSGS (IgM+, C3+/paramesangial dense deposits) | 40 | Negative | DM, AVR, aortic aneurysm | Pulse methylprednisolone ⇒ vancomycin, gentamicin, rifampicin | Plasmapheresis ⇒ recovery | [33] |
64/M | FSGS and mild interstitial inflammation (no mention) | 60 | Negative | Insidious mild renal dysfunction | Ceftriaxone, doxycycline | Complete recovery | [34] |