Brucella aortitis: the missing link

Rimar, Doron; Slobodin, Gleb; Boulman, Nina; Rozenbaum, Michael; Kaly, Lisa; Rosner, Itzhak

doi:10.1111/1756-185x.12169

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…1 Although we agree with most of the contents of their letter, we think that the authors have not sufficiently addressed the problem of brucellar aortitis and its potential coexistence with brucellar spondylitis. They stated that in the English literature there are no reports of brucella aortitis and that overall there are 12 case reports of brucellar aortic aneurysms, five of which involved the ascending aorta and seven involved the abdominal aorta.…”

mentioning

confidence: 62%

Brucella aortitis: an underdiagnosed and under‐reported disease

Iaria

2014

Int J of Rheum Dis

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mentioning

confidence: 62%

Brucella aortitis: an underdiagnosed and under‐reported disease

Iaria

2014

Int J of Rheum Dis

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“…But the brucellosis was not diagnosed then and the aneurysm was thought to be the result of hypertension and resection and stent implantation surgery were performed. But we still suspected brucellosis infection was the cause of abdominal aneurysm because brucella aortic aneurysm may result from hematogenous planting of atheromatous plaques [32].…”

Section: Discussionmentioning

confidence: 99%

“…The application of corticosteroids improved the prognosis of renal injury associated with brucellosis. The corticosteroid was applied when the speci c antimicrobial agent didn't work or when the patient was accompanied by rapid progressive renal insu ciency, nephrotic proteinuria, aortitis or accompanied with vasculitis [23,[31][32][33].…”

Section: Discussionmentioning

confidence: 99%

Coexistence of cryoglobulinemia and ANCA-associated vasculitis in a chronic brucellosis patient -A case report and literature review

Jiao

Liu

et al. 2022

Preprint

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Background The renal involvement of brucellosis is not common. Here we reported a rare case of chronic brucellosis accompanied by nephritic syndrome, acute kidney injury, the coexistence of cryoglobulinemia and antineutrophil cytoplasmic autoantibodies (ANCA) associated vasculitis (AAV) superimposed on iliac aortic stent implantation. The diagnosis and treatment of the case are instructive. Case presentation A 49-year-old man with hypertension and iliac aortic stent implantation was admitted for unexplained renal failure with signs of nephritic syndrome, congestive heart failure, moderate anemia and livedoid change in the left sole with pain. Past history included chronic brucellosis and he just underwent the recurrence and completed the 6 weeks of antibiotics treatment. He demonstrated positive cytoplasmic/proteinase 3 ANCA, mixed type cryoglobulinemia and decreased C3. The kidney biopsy revealed endocapillary proliferative glomerulonephritis with a small amount of crescent formation. Immunofluorescence staining revealed only C3 positive staining. In accordance with clinical and laboratory findings, post-infective acute glomerulonephritis superimposed with AAV was diagnosed. The patient was treated with corticosteroid and antibiotics and sustained alleviation of renal function and brucellosis was achieved during the course of a 3-month follow-up. Conclusions Here we describe the diagnostic and treatment challenge in a patient with chronic brucellosis related glomerulonephritis accompanied by the coexistence of AAV and cryoglobulinemia. Renal biopsy confirmed the diagnosis of postinfectious acute glomerulonephritis overlapping with ANCA related crescentic glomerulonephritis, which was not ever reported in the literature. The patient showed good respond to steroid treatment which indicated the immunity-induced kidney injury. Meanwhile it is essential to recognize and actively treat the coexisting brucellosis even when there are no clinical signs of the active stage of infection. This is the critical point for a salutary patient outcome for brucellosis associated renal complications.

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“…But the brucellosis was not diagnosed then and the aneurysm was thought to be the result of hypertension and resection and stent implantation surgery were performed. But we still suspected brucellosis infection was the cause of the abdominal aneurysm because brucella aortic aneurysm may result from hematogenous planting of atheromatous plaques [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Coexistence of cryoglobulinemia and ANCA-associated vasculitis in a chronic brucellosis patient -a case report and literature review

Jiao

Liu

et al. 2023

BMC Infect Dis

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Background The renal involvement of brucellosis is not common. Here we reported a rare case of chronic brucellosis accompanied by nephritic syndrome, acute kidney injury, the coexistence of cryoglobulinemia and antineutrophil cytoplasmic autoantibodies (ANCA) associated vasculitis (AAV) superimposed on iliac aortic stent implantation. The diagnosis and treatment of the case are instructive. Case presentation A 49-year-old man with hypertension and iliac aortic stent implantation was admitted for unexplained renal failure with signs of nephritic syndrome, congestive heart failure, moderate anemia and livedoid change in the left sole with pain. His past history included chronic brucellosis and he just underwent the recurrence and completed the 6 weeks of antibiotics treatment. He demonstrated positive cytoplasmic/proteinase 3 ANCA, mixed type cryoglobulinemia and decreased C3. The kidney biopsy revealed endocapillary proliferative glomerulonephritis with a small amount of crescent formation. Immunofluorescence staining revealed only C3-positive staining. In accordance with clinical and laboratory findings, post-infective acute glomerulonephritis superimposed with AAV was diagnosed. The patient was treated with corticosteroids and antibiotics and sustained alleviation of renal function and brucellosis was achieved during the course of a 3-month follow-up. Conclusions Here we describe the diagnostic and treatment challenge in a patient with chronic brucellosis related glomerulonephritis accompanied by the coexistence of AAV and cryoglobulinemia. Renal biopsy confirmed the diagnosis of postinfectious acute glomerulonephritis overlapping with ANCA related crescentic glomerulonephritis, which was not ever reported in the literature. The patient showed a good response to steroid treatment which indicated the immunity-induced kidney injury. Meanwhile, it is essential to recognize and actively treat the coexisting brucellosis even when there are no clinical signs of the active stage of infection. This is the critical point for a salutary patient outcome for brucellosis associated renal complications.

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Brucella aortitis: the missing link

Cited by 6 publications

References 10 publications

Brucella aortitis: an underdiagnosed and under‐reported disease

Brucella aortitis: an underdiagnosed and under‐reported disease

Coexistence of cryoglobulinemia and ANCA-associated vasculitis in a chronic brucellosis patient -A case report and literature review

Coexistence of cryoglobulinemia and ANCA-associated vasculitis in a chronic brucellosis patient -a case report and literature review

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