Mixed cryoglobulinemia and secondary membranoproliferative glomerulonephritis associated with ehrlichiosis

CEN Case Reports
Dawn J CasterKenneth R McLeish

Abstract

Ehrlichiosis is a tick-borne disease with diverse clinical presentations, ranging in severity from a flu-like illness with fever and myalgias to a serious systemic disease with multisystem organ failure. Nephrotic syndrome has been reported previously in two cases of human ehrlichiosis. A kidney biopsy revealed minimal change disease in one of those patients. Herein, we present the case of a 40-year-old man with ehrlichiosis who developed nephrotic syndrome, cryoglobulinemia, and secondary membranoproliferative glomerulonephritis (MPGN). The patient originally presented with shortness of breath, diffuse myalgias, headache, and lower extremity edema. He subsequently developed acute kidney injury and underwent kidney biopsy which showed MPGN and acute tubular injury. A tick-borne disease panel was positive for IgM and IgG to Ehrlichia chaffeensis. Serum testing revealed type 3 mixed cryoglobulinemia with no evidence of hepatitis C infection. The cryoprecipitate contained IgM and IgG antibodies to E. chaffeensis. Cryoglobulinemia is frequently associated with infections, particularly hepatitis C; however, our case is the first to describe ehrlichiosis associated with cryoglobulinemia and secondary MPGN.

References

May 1, 1997·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·D SansonnoF Dammacco
Aug 25, 1999·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·F ScagliaA Maki
Nov 6, 2002·Annals of Internal Medicine·Matthew L Esson, Robert W Schrier
Jan 15, 2003·Clinical Microbiology Reviews·Christopher D Paddock, James E Childs
Jun 11, 2005·Allergologia et immunopathologia·J C Miralles LópezJ M Negro Alvarez
Sep 18, 2008·Orphanet Journal of Rare Diseases·Clodoveo Ferri
Jun 2, 2010·Clinics in Laboratory Medicine·Nahed IsmailJere W McBride
Aug 11, 2010·The American Journal of the Medical Sciences·Linda J SalinasGene W Voskuhl
Aug 27, 2011·Lancet·Manuel Ramos-CasalsXavier Bosch
Jan 13, 2012·Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi·Yu-Ting LiouKuo-Wei Yeh
Mar 23, 2012·The New England Journal of Medicine·Sanjeev Sethi, Fernando C Fervenza
Sep 26, 2012·Renal Failure·Maria Brandão TavaresWashington Luis Conrado dos-Santos

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Citations

Jan 4, 2019·Journal of Veterinary Internal Medicine·Barbara A QurolloAlaire Comyn

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