A nephrotic syndrome of tropical origin: case report and short review of the aetiology

Halleux, Delphine; Moerman, Filip; Gavage, Pierre; Carpentier, M.; Esbroeck, Marjan Van; Craenen, S.; Firre, Éric; Moonen, Martial; Warling, Xavier; Masset, Catherine; Radermacher, Luc

doi:10.1179/2295333714y.0000000057

Cited by 5 publications

(3 citation statements)

References 5 publications

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“…malariae infection, is mostly described in children living in endemic areas [ 32 ] with few cases reported since the mid-1970s [ 32 – 34 ]. Renal biopsies in two recent cases have shown chronic membranous glomerulopathy [ 34 ] and mesangioproliferative glomerulonephritis respectively [ 33 ]. The syndrome has been reported as being hard to treat and often unresponsive to corticosteroids, immunosuppressive agents and antimalarial drugs [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Plasmodium malariae Infection Associated with a High Burden of Anemia: A Hospital-Based Surveillance Study

et al. 2015

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Background Plasmodium malariae is a slow-growing parasite with a wide geographic distribution. Although generally regarded as a benign cause of malaria, it has been associated with nephrotic syndrome, particularly in young children, and can persist in the host for years. Morbidity associated with P. malariae infection has received relatively little attention, and the risk of P. malariae-associated nephrotic syndrome is unknown.Methodology/Principal FindingsWe used data from a very large hospital-based surveillance system incorporating information on clinical diagnoses, blood cell parameters and treatment to describe the demographic distribution, morbidity and mortality associated with P. malariae infection in southern Papua, Indonesia. Between April 2004 and December 2013 there were 1,054,674 patient presentations to Mitra Masyarakat Hospital of which 196,380 (18.6%) were associated with malaria and 5,097 were with P. malariae infection (constituting 2.6% of all malaria cases). The proportion of malaria cases attributable to P. malariae increased with age from 0.9% for patients under one year old to 3.1% for patients older than 15 years. Overall, 8.5% of patients with P. malariae infection required admission to hospital and the median length of stay for these patients was 2.5 days (Interquartile Range: 2.0–4.0 days). Patients with P. malariae infection had a lower mean hemoglobin concentration (9.0g/dL) than patients with P. falciparum (9.5g/dL), P. vivax (9.6g/dL) and mixed species infections (9.3g/dL). There were four cases of nephrotic syndrome recorded in patients with P. malariae infection, three of which were in children younger than 5 years old, giving a risk in this age group of 0.47% (95% Confidence Interval; 0.10% to 1.4%). Overall, 2.4% (n = 16) of patients hospitalized with P. malariae infection subsequently died in hospital, similar to the proportions for the other endemic Plasmodium species (range: 0% for P. ovale to 1.6% for P. falciparum).Conclusions/Significance Plasmodium malariae infection is relatively uncommon in Papua, Indonesia but is associated with significant morbidity from anemia and a similar risk of mortality to patients hospitalized with P. falciparum and P. vivax infection. In our large hospital database, one in 200 children under the age of 5 years with P. malariae infection were recorded as having nephrotic syndrome.

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Section: Discussionmentioning

confidence: 99%

Plasmodium malariae Infection Associated with a High Burden of Anemia: A Hospital-Based Surveillance Study

et al. 2015

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“…Eosinophilia has been associated with nephrotic syndrome in the context of parasitic infestations in the tropics. 8 In a large biopsy-based series of 2,827 patients with renal disease, it was found that 10% to 21% of patients had associated eosinophilia and amongst membranous glomerulonephritis, 14.4% had eosinophilia. 9…”

Section: Eosinophilia and Nephrotic Syndromementioning

confidence: 99%

Carotid Occlusion Associated With Eosinophilia and Proteinuria: Potential Diagnostic Clues or Red Herrings?

Elavarasi

Narayan

Parameswaran

et al. 2022

Journal of Stroke Medicine

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Nephrotic syndrome and hypereosinophilic syndrome both are uncommon causes of arterial stroke. We had a young patient with internal carotid artery occlusion, who had both these rare associations and was found to have membranous nephropathy. Idiopathic hypereosinophilia was treated with corticosteroids and conventional parasiticidal therapy with the intention of bringing down the eosinophil count. Nephrotic syndrome was also treated with corticosteroids and immunosuppression with cyclophosphamide. Hematologic abnormalities are an important cause of arterial thrombosis with effective secondary prevention strategies. Similarly, nephrotic syndrome is not to be missed as early treatment may prevent vascular complications. While cause-effect associations remained presumptive and a single diagnostic label elusive, the patient was recognized and treated early and had a good prognosis. However, other common causes of stroke should always be worked up for, and vigilant follow-up mandatory for prevention and treatment of recurrences which can have devastating sequelae such as total blindness and other vascular outcomes.

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“…The parasite density is always low compared to Plasmodium falciparum and it produces clinical relapses due to the asexual forms that persist in the host's blood [17]. Symptoms include nephropathies [19][20][21][22][23], a long asymptomatic persistence of several years before access to recrudescence [24] that may induce transfusional malaria [25], genetic polymorphism [26][27][28][29], transmission by palearctic or tropical vectors [30,31], and due to its possibility to infect human and simian subjects [32], it was considered as an anthropozoonosis.…”

Section: Introductionmentioning

confidence: 99%

First Observations of Plasmodium Malariae and Its Evolution During the Parasitological Evaluation of the Long-term Village Scale Malaria Vector Control Program in the Balombo Area of Angola

Manguin

Foumane

Toto

et al. 2021

Preprint

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Background: A long-term village scale vector control program was implemented in eight villages around the Balombo town (Benguela Province, Angola) to compare the efficacy of four methods of vector control inside houses including long-lasting deltamethrin insecticide treated nets (PermaNet© 2.0 model or P.2.0); association of P.2.0 and deltamethrin Insecticide Treated Plastic Sheeting (ITPS)-Zero Fly© model; deltamethrin ITPS-Wall Lining model alone; and 2 rounds of lambdacyhalothrin Inside Residual Spraying followed by installation of ITPS.Methods: Cross sectional parasitological surveys (CSS) were done every two months. Thick blood films (TBF) were microscopically examined at the Medical Department of the Angolese Sonamet company in Lobito and a sample of them were double-checked in Yaoundé. Plasmodium species determination, parasitaemia and gametocytes presence, and evolution in time were analyzed.Results: A total of 190 CSS was done between 2007 and 2011, Plasmodium spp. were observed in 5,431 of the 21,804 TBF done. Plasmodium malariae alone was observed in 22 TBF (0.4%) and mixed infections P. falciparum and P. malariae in 44 TBF (0.8%).Conclusion: The very low frequency of P. malariae could explain the fact it is usually not reported in classical point prevalence surveys. Our study confirms the presence of this species in Angola, which must be known due to its special clinical impact, quartan fever, kidney failure, chronicity, symptomless carriers, persistence for several years with long term recrudescence and reported cases of resistance to classical ACTs. The prevalence of P. malariae decreased after implementation of vector control methods.

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A nephrotic syndrome of tropical origin: case report and short review of the aetiology

Cited by 5 publications

References 5 publications

Plasmodium malariae Infection Associated with a High Burden of Anemia: A Hospital-Based Surveillance Study

Plasmodium malariae Infection Associated with a High Burden of Anemia: A Hospital-Based Surveillance Study

Carotid Occlusion Associated With Eosinophilia and Proteinuria: Potential Diagnostic Clues or Red Herrings?

First Observations of Plasmodium Malariae and Its Evolution During the Parasitological Evaluation of the Long-term Village Scale Malaria Vector Control Program in the Balombo Area of Angola

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