Proteinase 3-antineutrophil cytoplasmic antibody-positive necrotizing crescentic glomerulonephritis complicated by infectious endocarditis: a case report.
Infective endocarditis
Necrotizing crescentic glomerulonephritis
Proteinase 3-antineutrophil cytoplasmic antibody
Journal
Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382
Informations de publication
Date de publication:
05 Dec 2019
05 Dec 2019
Historique:
received:
13
06
2019
accepted:
02
10
2019
entrez:
6
12
2019
pubmed:
6
12
2019
medline:
18
6
2020
Statut:
epublish
Résumé
Proteinase 3-antineutrophil cytoplasmic antibody has been reported to be positive in 5-10% of cases of renal injury complicated by infective endocarditis; however, histological findings have rarely been reported for these cases. A 71-year-old Japanese man with a history of aortic valve replacement developed rapidly progressive renal dysfunction with gross hematuria and proteinuria. Blood analysis showed a high proteinase 3-antineutrophil cytoplasmic antibody (163 IU/ml) titer. Streptococcus species was detected from two separate blood culture bottles. Transesophageal echocardiography detected mitral valve vegetation. Histological evaluation of renal biopsy specimens showed necrosis and cellular crescents in glomeruli without immune complex deposition. The patient met the modified Duke criteria for definitive infective endocarditis. On the basis of these findings, the patient was diagnosed with proteinase 3-antineutrophil cytoplasmic antibody-positive necrotizing crescentic glomerulonephritis complicated by Streptococcus infective endocarditis. His renal disease improved, and his proteinase 3-antineutrophil cytoplasmic antibody titer normalized with antibiotic monotherapy. Few case reports have described histological findings of proteinase 3-antineutrophil cytoplasmic antibody-positive renal injury complicated with infective endocarditis. We believe that an accumulation of histological findings and treatments is mandatory for establishment of optimal management for proteinase 3-antineutrophil cytoplasmic antibody-positive renal injury complicated with infective endocarditis.
Sections du résumé
BACKGROUND
BACKGROUND
Proteinase 3-antineutrophil cytoplasmic antibody has been reported to be positive in 5-10% of cases of renal injury complicated by infective endocarditis; however, histological findings have rarely been reported for these cases.
CASE PRESENTATION
METHODS
A 71-year-old Japanese man with a history of aortic valve replacement developed rapidly progressive renal dysfunction with gross hematuria and proteinuria. Blood analysis showed a high proteinase 3-antineutrophil cytoplasmic antibody (163 IU/ml) titer. Streptococcus species was detected from two separate blood culture bottles. Transesophageal echocardiography detected mitral valve vegetation. Histological evaluation of renal biopsy specimens showed necrosis and cellular crescents in glomeruli without immune complex deposition. The patient met the modified Duke criteria for definitive infective endocarditis. On the basis of these findings, the patient was diagnosed with proteinase 3-antineutrophil cytoplasmic antibody-positive necrotizing crescentic glomerulonephritis complicated by Streptococcus infective endocarditis. His renal disease improved, and his proteinase 3-antineutrophil cytoplasmic antibody titer normalized with antibiotic monotherapy.
CONCLUSION
CONCLUSIONS
Few case reports have described histological findings of proteinase 3-antineutrophil cytoplasmic antibody-positive renal injury complicated with infective endocarditis. We believe that an accumulation of histological findings and treatments is mandatory for establishment of optimal management for proteinase 3-antineutrophil cytoplasmic antibody-positive renal injury complicated with infective endocarditis.
Identifiants
pubmed: 31801609
doi: 10.1186/s13256-019-2287-1
pii: 10.1186/s13256-019-2287-1
pmc: PMC6894315
doi:
Substances chimiques
Anti-Bacterial Agents
0
Antibodies, Antineutrophil Cytoplasmic
0
Myeloblastin
EC 3.4.21.76
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
356Références
Cardiology. 2009;114(3):208-11
pubmed: 19602882
Presse Med. 2013 Jun;42(6 Pt 1):1060-1
pubmed: 23079393
Am J Nephrol. 1993;13(3):218-22
pubmed: 8213935
Case Rep Nephrol. 2015;2015:649763
pubmed: 26819786
Clin Nephrol. 1998 Jan;49(1):15-8
pubmed: 9491280
Int Urol Nephrol. 2008;40(2):461-70
pubmed: 18247152
Pediatr Infect Dis J. 2017 May;36(5):516-520
pubmed: 28403058
Case Rep Nephrol Urol. 2012 Jan;2(1):25-32
pubmed: 23197952
Clin Kidney J. 2013 Jun;6(3):300-4
pubmed: 26064489
Int Urol Nephrol. 1990;22(1):77-88
pubmed: 2380006
Kidney Int. 2013 May;83(5):792-803
pubmed: 23302723
Am Fam Physician. 2012 May 15;85(10):981-6
pubmed: 22612050
J Clin Microbiol. 2007 Dec;45(12):4081-4
pubmed: 17942646
BMC Nephrol. 2012 Dec 26;13:174
pubmed: 23268737
Clin Nephrol. 2006 Sep;66(3):202-9
pubmed: 16995343
Infect Dis Clin Pract (Baltim Md). 2016 Sep;24(5):254-260
pubmed: 27885316
Case Rep Nephrol Dial. 2017 Nov 27;7(3):138-143
pubmed: 29594142
Am J Kidney Dis. 2014 Jun;63(6):1060-5
pubmed: 24332768
Clin Nephrol. 2006 Dec;66(6):447-54
pubmed: 17176917
Front Immunol. 2014 Sep 12;5:432
pubmed: 25309534
Nephrol Dial Transplant. 1998 Aug;13(8):2142-6
pubmed: 9719187
Case Rep Nephrol. 2014;2014:569047
pubmed: 25506445
Clin Infect Dis. 1999 Jun;28(6):1342-3
pubmed: 10451193
Clin Nephrol. 2018 Dec;90(6):431-433
pubmed: 30369400
NDT Plus. 2011 Jun;4(3):208-210
pubmed: 23227113
Clin Kidney J. 2014 Apr;7(2):179-81
pubmed: 25852867
Am J Kidney Dis. 1984 Mar;3(5):371-9
pubmed: 6702824
Caspian J Intern Med. 2012 Summer;3(3):496-9
pubmed: 24009921
Kidney Int. 2015 Jun;87(6):1241-9
pubmed: 25607109
Pediatr Nephrol. 2001 May;16(5):423-8
pubmed: 11405117
Clin Nephrol Case Stud. 2017 Apr 26;5:32-37
pubmed: 29043145
Am J Kidney Dis. 2012 Jan;59(1):A28-31
pubmed: 22177451
Int J Surg Case Rep. 2017;31:150-153
pubmed: 28152491
Lancet. 1991 Mar 30;337(8744):799-800
pubmed: 1672428
Case Rep Nephrol. 2018 Aug 19;2018:9607582
pubmed: 30210883