Crescentic glomerulonephritis associated with syphilis: a case report and review of the literature

J Med Case Rep. 2023 Dec 22;17(1):549. doi: 10.1186/s13256-023-04293-2.

Abstract

Background: Crescentic glomerulonephritis with syphilis infection is rare, and the mechanism underlying the formation of glomerular capillary wall damage-induced crescent has not been elucidated.

Case presentation: A 62-year-old Japanese male showed edema, eruption, and rapid deterioration of the renal function after an acute syphilis infection. A renal biopsy showed crescentic glomerulonephritis with C3 deposition in the glomerular capillary wall, and immunostaining for anti-Treponema pallidum antibody was weakly positive in some interstitium and one glomerulus. Electron microscopy revealed the presence of string-shaped structures in the glomerular capillary walls. After treatment with penicillin followed by prednisolone, the renal function and urinary abnormalities, including Treponema pallidum protein, disappeared.

Conclusions: Crescentic glomerulonephritis associated with syphilis showed a string-shaped deposition in the glomerular capillary and urinary Treponema pallidum protein excretion, and was effectively treated with penicillin and prednisolone.

Keywords: Crescentic glomerulonephritis; Electron microscopy; Rapidly progressive glomerulonephritis; Syphilis.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Acute Disease
  • Glomerulonephritis* / complications
  • Glomerulonephritis* / drug therapy
  • Humans
  • Kidney Glomerulus / blood supply
  • Kidney Glomerulus / pathology
  • Male
  • Middle Aged
  • Penicillins / therapeutic use
  • Prednisolone / therapeutic use
  • Syphilis* / complications
  • Syphilis* / diagnosis
  • Syphilis* / drug therapy

Substances

  • Penicillins
  • Prednisolone

Supplementary concepts

  • Japanese people