A case of post-pneumococcal acute glomerulonephritis with glomerular depositions of nephritis-associated plasmin receptor

CEN Case Reports
Jun OdakaTakanori Yamagata

Abstract

We report the case of a 12-year-old girl who was referred to our hospital with anuria associated with pneumonia. On admission, the patient's blood test results revealed severe renal failure, hypoproteinemia, and hypocomplementemia. Her urinalysis results revealed hematuria, proteinuria, and a positive titer for Streptococcus pneumoniae. S. pneumoniae was also detected in her sputum and blood cultures. The patient was diagnosed with post-pneumococcal acute glomerulonephritis (AGN) with acute renal failure. A renal biopsy demonstrated the infiltration of neutrophils and mononuclear cells into capillary loops. Immunofluorescence studies showed dominant-positive deposition of C3c along the capillary loops and nephritis-associated plasmin receptor (NAPlr) depositions in the mesangial area and capillary loops. Electron microscopy revealed dense deposits in the glomerular basement membrane without a hump in the subepithelial area. These findings were consistent with endocapillary proliferative glomerulonephritis. AGN associated with pneumococcal infection is very rare. This case suggests that NAPlr is the causative antigen not only of post-streptococcal AGN, but also of post-pneumococcal AGN. To our knowledge, this is the first report...Continue Reading

References

Jun 1, 1975·The American Journal of Medicine·L R HymanP M Burkholder
Jul 13, 2005·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Joshua PhillipsRadhakrishna Baliga
Aug 12, 2009·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Fernando Carceller LechónJose Luis Écija Peiró
Feb 22, 2011·Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)·J Vila CotsM Ramos Cebrian

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Citations

Jan 20, 2019·Clinical Pediatrics·Mafalda CascaisAntónio Jorge Correia
Jan 23, 2021·International Journal of Molecular Sciences·Takashi Oda, Nobuyuki Yoshizawa

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