Syphilis as the great mimicker: A case of full-house pattern membranous nephropathy.
biopsy
glomerulonephritis
membranous glomerulonephritis
nephrotic syndrome
syphilis
Journal
Nephrology (Carlton, Vic.)
ISSN: 1440-1797
Titre abrégé: Nephrology (Carlton)
Pays: Australia
ID NLM: 9615568
Informations de publication
Date de publication:
Jan 2024
Jan 2024
Historique:
received:
30
08
2023
accepted:
07
09
2023
pubmed:
19
9
2023
medline:
19
9
2023
entrez:
19
9
2023
Statut:
ppublish
Résumé
Syphilis is a known cause of membranous nephropathy. We describe a case of a patient presenting with nephrotic syndrome whose renal biopsy demonstrated a 'full house' immunohistochemical pattern with positive IgG, IgM, C1q, IgA, C3c, and C4d staining. He was treated with immunosuppressive agents for minimal change nephropathy and subsequently class V lupus nephritis, before syphilis infection was confirmed. Following treatment with a single dose of intramuscular benzathine penicillin there was complete and rapid resolution of nephrotic syndrome. With progressive rising incidence in the western world, syphilis is an important and under-recognised differential diagnosis in cases of nephrotic syndrome.
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
18-20Informations de copyright
© 2023 Asian Pacific Society of Nephrology.
Références
Hook EW. Syphilis. The Lancet. 2017;389:1550-1557.
Shettigar R, Schollum J, Putt T, Chan L, Lau M, Walker R. Renal manifestations of syphilis. Intern Med J. 2021;51:1160-1167.
Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2021: Syphilis; 2023. Accessed 30 April, 2023. https://www.cdc.gov/std/statistics/2021/overview.htm#Syphilis
Gamble CN, Reardon JP. Immunopathogenesis of syphilitic glomerulonephritis. Elution of antitreponemal antibody from glomerular immune-complex deposits. New Engl J Med. 1975;292(9):449-454.
Inayat F, Almas T, Bokhari SRA, Muhammad A, Sharshir MA. Membranous glomerulonephritis as an uncommon presentation of secondary syphilis: a reminder on therapeutic decision-making in clinical practice. J Investig Med High Impact Case Rep. 2020;8:2324709620967212.
Solomon MM, Lama JR, Glidden DV, et al. Changes in renal function associated with oral emtricitabine/tenofovir disoproxil fumarate use for HIV pre-exposure prophylaxis. Aids. 2014;28(6):851-859. doi:10.1097/QAD.0000000000000156