A case of Tsutsugamushi disease presenting with nephrotic syndrome

Korean J Intern Med. 2013 Nov;28(6):728-31. doi: 10.3904/kjim.2013.28.6.728. Epub 2013 Oct 29.

Abstract

Nephrotic syndrome associated with Tsutsugamushi disease has not been previously reported. We are describing a case of Tsutsugamuchi disease presenting with nephrotic syndrome. A 72-year-old woman presented with fever and generalized edema. Laboratory studies revealed a leukocytosis, hypoalbuminemia, and hypercholesterolemia. Her urine protein excretion was 5.4 g/day. The anti-Tsutsugamushi antibody test was strongly positive (1:2,560). A renal biopsy was performed, and pathologic findings revealed membranous glomerulonephritis. The patient's clinical symptoms improved markedly after treatment with doxycycline.

Keywords: Glomerulonephritis; Membranous; Nephrotic syndrome; Scrub typhus.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Antibodies, Bacterial / blood
  • Biopsy
  • Doxycycline / therapeutic use
  • Female
  • Glomerulonephritis, Membranous / diagnosis
  • Glomerulonephritis, Membranous / etiology*
  • Humans
  • Nephrotic Syndrome / diagnosis
  • Nephrotic Syndrome / etiology*
  • Orientia tsutsugamushi / immunology
  • Scrub Typhus / complications*
  • Scrub Typhus / diagnosis
  • Scrub Typhus / drug therapy
  • Scrub Typhus / microbiology
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Antibodies, Bacterial
  • Doxycycline