Streptococcal Infection-related Nephritis (SIRN) Manifesting Membranoproliferative Glomerulonephritis Type I

Intern Med. 2016;55(6):647-50. doi: 10.2169/internalmedicine.55.5409. Epub 2016 Mar 15.

Abstract

We herein report the case of an 18-year-old boy who developed nephrotic syndrome and hypertension after upper airway inflammation. Post-streptococcal acute glomerulonephritis was diagnosed on the basis of a high antistreptolysin O titer, hypocomplementemia, proteinuria, and microscopic hematuria. A renal biopsy was performed due to persistent proteinuria, and the pathological diagnosis was membranoproliferative glomerulonephritis (MPGN) type I. Glomeruli showed positive staining for nephritis-associated plasmin receptor (NAPlr), a nephritogenic group A streptococcal antigen, and plasmin activity was found in a similar distribution as NAPlr deposition. This rare case of streptococcal infection-related nephritis (SIRN) manifesting MPGN type I supports the histological diversity of SIRN.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antigens, Bacterial / isolation & purification
  • Biopsy
  • Edema / etiology
  • Glomerulonephritis, Membranoproliferative / diagnosis*
  • Glomerulonephritis, Membranoproliferative / microbiology*
  • Hematuria / etiology
  • Humans
  • Kidney Glomerulus / microbiology*
  • Kidney Glomerulus / pathology
  • Male
  • Nephrotic Syndrome / diagnosis*
  • Nephrotic Syndrome / microbiology*
  • Proteinuria / etiology
  • Receptors, Cell Surface / isolation & purification
  • Remission, Spontaneous
  • Streptococcal Infections / complications*
  • Streptococcal Infections / microbiology
  • Streptococcus pyogenes / immunology
  • Streptococcus pyogenes / isolation & purification*
  • Weight Gain

Substances

  • Antigens, Bacterial
  • Receptors, Cell Surface
  • nephritis-associated plasminogen receptor, Streptococcus