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Epstein barr glomerulonephritis

Jennifer Li, Marille Umakanathan, Chow Heok P'ng, Winny Varikatt, Fiona Kwok, Ming-Wei Lin, Mirna Vucak-Dzumhur
We present a unique case of cryoglobulinemic glomerulonephritis associated with nodal and renal infiltration by T-cell lymphoma of T-follicular helper phenotype. The patient presented with transient neurologic symptoms, severe nephritic syndrome with nephrotic-range proteinuria, and acute kidney injury. He had elevated double-stranded DNA levels, low complement levels, detectable cryoglobulin, and detectable immunoglobulin M (IgM) paraprotein. The kidney biopsy showed cryoglobulinemic glomerulonephritis with a membranoproliferative pattern and diffuse interstitial infiltrates on light microscopy; IgM, C3 but weak IgG, C1q, and negative C4d staining on immunofluorescence; and deposits with organized substructures on electron microscopy...
May 18, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Cherif Dial, Kwame Doh, Ibou Thiam, Mariam Faye, Gisèle Woto-Gaye
INTRODUCTION: Burkitt's lymphoma (BL) is an exceptional cause of acute renal failure (ARF). The origin of the tumor clone may be lymphoid follicles secondary to renal Epstein-Barr virus (EBV) infection. With the presentation of this clinical case, the pathogenesis, diagnostic criteria and evolution of this extremely rare affection will be discussed. OBSERVATION: A 4-year-old patient with a recent history of acute osteomyelitis of the right thigh presented an ARF without indications of post-infectious glomerulonephritis...
February 5, 2018: Néphrologie & Thérapeutique
Iolanda Godinho, Estela Nogueira, Sofia Jorge, António Teixeira Alves, António Gomes da Costa
BACKGROUND: Hemophagocytic syndrome (HPS) is a rare, aggressive disorder characterized by dysregulation of lymphocyte and macrophage activity, which culminates in tissue infiltration with hemophagocytosis and ultimately organ failure. Renal involvement frequently ensues and usually results in acute tubular necrosis with associated interstitial inflammation. Less frequently, glomerulopathy can also be found. CASE: We report a case of a 24-year-old Caucasian woman with previous asymptomatic hematuria, mild proteinuria, and normal renal function who presented to us with fever...
January 19, 2018: Clinical Nephrology
Francesco Fontana, Gianni Cappelli
BACKGROUND: Acute pancreatitis (AP) following KT is a rare and often fatal complication of the early post-transplant period. Common causative factors for AP are rare after KT; anti-rejection drugs as CyA, prednisone and MMF have been implicated, although evidence is not strong and we found no reports on possible causative role for mTOR inhibitors. CASE PRESENTATION: A 55-year-old Caucasian man with end-stage renal disease due to idiopathic membrano-prolipherative glomerulonephritis underwent single kidney transplantation (KT) from cadaveric donor...
October 28, 2016: BMC Nephrology
Terry King-Wing Ma, Stephen P McAdoo, Frederick Wai-Keung Tam
Spleen tyrosine kinase (Syk), a 72 kDa cytoplasmic non-receptor protein-tyrosine kinase, plays an important role in signal transduction in a variety of cell types. Ever since its discovery in the early 1990s, there has been accumulating evidence to suggest a pathogenic role of Syk in various allergic disorders, autoimmune diseases and malignancies. Additionally, there is emerging data from both pre-clinical and clinical studies that Syk is implicated in the pathogenesis of proliferative glomerulonephritis (GN), including anti-glomerular basement membrane disease, anti-neutrophil cytoplasmic antibody-associated GN, lupus nephritis and immunoglobulin A nephropathy (IgAN)...
2016: Nephron
Takahiro Tsuji, Masayoshi Miura, Mitsuru Yanai, Hiroe Itami, Yasushi Ishii, Mayuko Akimoto, Yuichiro Fukasawa
Proliferative glomerulonephritis with monoclonal immunoglobulin G (IgG) deposits (PGNMID) has recently been described in cases with glomerular disease. Only 16 cases of recurrent or de novo PGNMID have been reported in the transplanted kidney. Here we report a case of de novo PGNMID in a renal allograft diagnosed in the early stage by protocol biopsy. A 41-year-old male with end-stage kidney disease caused by focal glomerular sclerosis received a living-related kidney transplant. The post-transplantation course was stable, except for an early episode of acute T cell-mediated rejection...
July 2016: Nephrology
Benjamin Terrier, Isabelle Marie, Adeline Lacraz, Pauline Belenotti, Fabrice Bonnet, Laurent Chiche, Bruno Graffin, Arnaud Hot, Jean-Emmanuel Kahn, Catherine Michel, Thomas Quemeneur, Luc de Saint-Martin, Olivier Hermine, Jean-Marc Léger, Xavier Mariette, Patricia Senet, Emmanuelle Plaisier, Patrice Cacoub
In patients with infectious cryoglobulinemia vasculitis (CryoVas) in the absence of hepatitis C virus infection, data on presentation, therapeutic management and outcome are lacking. We conducted a nationwide survey that included patients with HCV-negative CryoVas. We describe here the presentation, therapeutic management and outcome of 18 patients with non-HCV infectious CryoVas and 27 additional patients identified form a systematic review of the literature. We included 18 patients, mean age 57.9±13.5 years...
December 2015: Journal of Autoimmunity
Giovanna A Giannico, Shanna Arnold, Anthony Langone, Heidi Schaefer, J Harold Helderman, David Shaffer, Agnes B Fogo
We have observed a predominantly mesangial non-immunoglobulin A immune complex mesangial glomerulopathy (MG) in renal transplants with mesangial deposits by immunofluorescence and electron microscopy. Clinicopathological features of 28 patients with MG were analyzed and compared with 28 transplant controls, matched for age, sex, ethnicity, donor type, estimated glomerular filtration rate, and interval from transplant to biopsy. Indications for biopsy in the MG group were allograft dysfunction in 64%, allograft dysfunction/proteinuria in 29%, and proteinuria in 7%...
October 2015: Human Pathology
Lazarus Karamadoukis, Tibor Toth, Charlie Tomson
Type 1 membranoproliferative glomerulonephritis (MPGN) is an immune complex-mediated disorder that has been associated with certain viral infections including hepatitis C, hepatitis B, hepatitis G, HIV and Hantavirus. We describe a patient with type 1 MPGN in native kidneys and nephrotic syndrome in whom there was strong evidence that a primary Epstein-Barr virus (EBV) infection played a causative role. This patient was treated with an angiotensin 2-receptor blocker and the nephrotic syndrome resolved within 6 months from presentation...
October 2008: NDT Plus
Nishimura Shinsuke, Inoue Hiroshi
To identify the effect of an imbalance of Th1/Th2 cytokines on the development of autoimmune glomerulonephritis (lupus nephritis), we studied the modification of pathological changes in diffuse proliferative glomerulonephritis (DPGN) and membranous glomerulonephritis (MGN) in MRL/lpr mice, which are animal models of systemic lupus erythematosus (SLE). Transgenic MRL/lpr mice (Tg) that overexpressed Epstein--Barr virus-induced gene 3 (EBI3) showed almost normal renal function, which was demonstrated by healing of glomerulonephritis upon renal histology, as compared to the wild-type MRL/lpr (Wt) mice...
November 2013: Autoimmunity
V Gómez, A Fernández, C Galeano, J Oliva, V Diez, C Bueno, V Hevia, F J Burgos
BACKGROUND: The use of highly active antiretroviral therapy (HAART) has decreased the morbidity and mortality in HIV-infected patients. The kidney transplantation (KT) survival rate is similar to that of HIV-negative transplant recipients. The consensus criteria for the selection of HIV patients for transplantation include: no opportunistic infections, CD4 lymphocyte count greater than 200 cells/μL, and an undetectable viral load. In Spain, HIV-infected patients present with different characteristics compared to American recipients; this could influence posttransplantation outcomes...
April 2013: Transplantation Proceedings
Mehdi Mirsaeidi, Fatima Syed, Elaine S Jaffe
INTRODUCTION: EBV has been a leading candidate as a trigger for several autoimmune diseases. We describe an antineutrophil cytoplasmic autoantibody (ANCA) -associated systemic vasculitis as the initial presenting illness of AIDS. CASE REPORT AND RESULTS: The patient was diagnosed ANCA -associated systemic vasculitis in the setting of HIV infection because of a high level of ANCA level, crescent glomerulonephritis in pathology, and clinical signs and symptoms compatible with systemic vasculitis...
January 2013: Infectious Diseases in Clinical Practice: IDCP
Preeti Chandra, Jeffrey B Kopp
BACKGROUND: Collapsing glomerulopathy may occur in an idiopathic (primary) form and in association with a wide spectrum of infectious and inflammatory conditions and medications. The association of collapsing glomerulopathy with human immunodeficiency virus (HIV)-1 infection is well established; less certain is the association with other viral infections. METHODS: We searched PubMed for articles in all languages that addressed glomerulopathies associated with parvovirus B19, cytomegalovirus (CMV), Epstein-Barr virus (EBV), hepatitis C virus (HCV) and simian virus 40 (SV40)...
February 2013: Clinical Kidney Journal
Chang Seong Kim, Yoo Duk Choi, Joon Seok Choi, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim
BACKGROUND: Sjögren's syndrome is a systemic autoimmune disease in which lymphatic cells destroy the salivary and lacrimal glands. Glomerulonephritis is thought to be a rare occurrence in primary Sjögren's syndrome. Furthermore, concurrent glomerular involvement and lymphoma in patients with Sjögren's syndrome has seldom been reported. CASE PRESENTATION: A 52-year-old woman with primary Sjögren's syndrome developed membranous glomerulonephritis and Epstein-Barr virus-positive diffuse large B-cell lymphoma (DLBCL)...
2012: BMC Nephrology
Tamami Watanabe, Hitoshi Sugawara, Hiroyuki Tamura, Akira Ishii, Hiroshi Matsubayashi, Masafumi Kakei, Shin-ichi Momomura
Acute pharyngitis is commonly encountered, but a definite etiological diagnosis is difficult. Although co-infection with Group A Streptococci (GAS) and Epstein-Barr virus (EBV) is uncommon, general physicians should consider the possibility of EBV co-infection in patients with GAS pharyngitis who fail to show prompt remission of symptoms following appropriate antibiotic treatment. In this article, we present a rare case of a 16-year-old girl who had co-infection with GAS and EBV. She developed acute glomerulonephritis and left ventricular dysfunction in an overlapping manner...
2012: Internal Medicine
Yoko Wada, Masaru Kojima, Kazuhiro Yoshita, Mihoko Yamazaki, Daisuke Kobayashi, Shuichi Murakami, Shinichi Nishi, Masaaki Nakano, Ichiei Narita
We report an intriguing case of Epstein-Barr virus (EBV)-related multiple lymphadenopathy that clinically mimics immunoglobulin G4-related disease (IgG4-RD). A 72-year-old woman presented with a history of asthma attacks, systemic lymphadenopathy, hypergammaglobulinemia, proteinuria, and an elevated level of serum IgG4, leading to a possible diagnosis of IgG4-RD based on current comprehensive diagnostic criteria. However, a percutaneous kidney biopsy specimen showed mild mesangial proliferative glomerulonephritis with focal membranous transformation, and there was no interstitial lesion or lymphocyte infiltration...
May 2013: Modern Rheumatology
M R Gumber, V B Kute, K R Goplani, P R Shah, A V Vanikar, H L Trivedi
The combination of NHL and documented malignancy-associated glomerulonephritis is uncommon. Also, no single renal pathological entity is consistently found in patients with NHL. Epstein-Barr virus (EBV) infection may manifest as systemic lupus erythematosus (SLE) and/or diffuse large cell lymphoma (DLBCL) in a genetically/ immunologically susceptible individual with defective cytotoxic T-cell response against EBV. We describe lupus nephritis in a 45 years old male suffering from untreated NHL. CD20+ DLBCL was demonstrated by immunohistochemistry of the neck lymph node (LN) biopsy performed for generalized lymphadenopathy...
August 2011: Journal of the Association of Physicians of India
Mark R Steciuk, Susan Massengill, Peter M Banks
The development of lymphomas and solid malignancies in association with immunosuppression is a well-documented occurrence in the medical literature. We report the case of a young man who developed progressive diffuse lymphadenopathy with associated extremely high levels of serum Epstein-Barr virus in the setting of chronic immunosuppressive treatment of glomerulonephritis. Excisional biopsy of a right inguinal node revealed a sclerosing process with the morphologic appearance of angioimmunoblastic T-cell lymphoma with a CD3(+), CD4(+) immunophenotype...
January 2012: Human Pathology
Mirna Subat-Dezulović, Nada Sindifić Dessardo, Matko Dezulović, Sandro Dessardo, Ita Hadzisejdić, Nada Brncic
Contrary to group A beta-hemolytic streptococcus as the most common cause of postinfectious glomerulonephritis (PIGN), Epstein-Barr virus (EBV) is only occasionally associated with acute renal involvement. We describe an 11-year-old boy who presented with clinical signs of infective mononucleosis and acute glomerulonephritis characterized by edema, hypertension and dark colored urine with diminished renal function. Serology tests confirmed streptococcal infection and acute EBV infection. Persistently depressed C3 complement and gross hematuria indicated renal biopsy which shows PIGN-type picture and, in addition, acute interstitial nephritis, both conclusive of streptococcal infection...
April 2010: Collegium Antropologicum
A Patrick, A Wee, A Hedderman, D Wilson, J Weiss, M Govani
Primary central nervous system (CNS) posttransplant lymphoproliferative disorder (PTLD) is a well-recognized but rare complication of solid organ transplantation. Most of these disorders are B-cell in origin and generally carry poor prognosis. Rituximab, an anti-CD20 monoclonal antibody, has been used effectively in patients with systemic PTLD. However, its role in primary CNS PTLD is doubtful because it does not cross blood-brain barrier efficiently (<5%). Also, mechanisms, by which rituximab operates are not optimally effective in CNS...
July 2011: Journal of Neuro-oncology
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