Granulomatosis With Polyangiitis Induced by Infection

Kohatsu, Kaori; Suzuki, Tomo; Yazawa, Masahiko; Yahagi, Koichi; Ichikawa, Daisuke; Koike, Junki; Oda, Takashi; Shibagaki, Yugo

doi:10.1016/j.ekir.2018.09.010

Cited by 6 publications

(5 citation statements)

References 9 publications

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“…The unique glomerular staining patterns of NAPlr and plasmin activity were found not only in patients with PSAGN but also in some patients with other glomerular diseases, such as C3 glomerulopathy [18,19], membranoproliferative glomerulonephritis (MPGN) type I [20,21], antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (both ANCA positive [22] and negative [23]), and IgA vasculitis [24], in which a preceding streptococcal infection is suggested by serological markers, and these cases are referred to as SIRN [2,25]. Although prominent endocapillary proliferation is a common histological feature, the differences in immune responses of the affected hosts may affect the specific histology.…”

Section: Streptococcal Infection-related Nephritis (Sirn): Glomerularmentioning

confidence: 99%

Glomerular Deposition of Nephritis-Associated Plasmin Receptor (NAPlr) and Related Plasmin Activity: Key Diagnostic Biomarkers of Bacterial Infection-related Glomerulonephritis

Uchida

Oda

2020

IJMS

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It is widely known that glomerulonephritis (GN) often develops after the curing of an infection, a typical example of which is GN in children following streptococcal infections (poststreptococcal acute glomerulonephritis; PSAGN). On the other hand, the term “infection-related glomerulonephritis (IRGN)” has recently been proposed, because infections are usually ongoing at the time of GN onset in adult patients, particularly in older patients with comorbidities. However, there has been no specific diagnostic biomarker for IRGN, and diagnosis is based on the collection of several clinical and pathological findings and the exclusion of differential diagnoses. Nephritis-associated plasmin receptor (NAPlr) was originally isolated from the cytoplasmic fraction of group A streptococcus as a candidate nephritogenic protein for PSAGN and was found to be the same molecule as streptococcal glyceraldehyde-3-phosphate dehydrogenase and plasmin receptor. NAPlr deposition and related plasmin activity were observed with a similar distribution pattern in the glomeruli of patients with PSAGN. However, glomerular NAPlr deposition and plasmin activity could be observed not only in patients with PSAGN but also in patients with other glomerular diseases, in whom a preceding streptococcal infection was suggested. Furthermore, such glomerular staining patterns have been demonstrated in patients with IRGN induced by bacteria other than streptococci. This review discusses the recent advances in our understanding of the pathogenesis of bacterial IRGN, which is characterized by NAPlr and plasmin as key biomarkers.

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Section: Streptococcal Infection-related Nephritis (Sirn): Glomerularmentioning

confidence: 99%

Glomerular Deposition of Nephritis-Associated Plasmin Receptor (NAPlr) and Related Plasmin Activity: Key Diagnostic Biomarkers of Bacterial Infection-related Glomerulonephritis

Uchida

Oda

2020

IJMS

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“…Recently, Oda et al proposed the entity of SIRN based on positivity for glomerular NAPlr deposition and plasmin activity in various glomerular diseases, including AAV ( 2 , 18 ). ANCA-positive granulomatosis with polyangiitis with glomerular NAPlr deposition was also reported ( 19 ). In our case, glomerular NAPlr deposition was negative.…”

Section: Discussionmentioning

confidence: 97%

Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis Superimposed on Post-streptococcal Acute Glomerulonephritis

et al. 2022

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A 44-year-old woman was admitted due to gross hematuria and progressive renal dysfunction. Poststreptococcal acute glomerulonephritis (PSAGN) was suspected due to her elevated anti-streptolysin O and antistreptokinase titers and hypocomplementemia. A renal biopsy showed crescent formation and endocapillary hypercellularity with neutrophil infiltrate. An immunofluorescence analysis showed granular immunoglobulin G and C3 deposition, suggesting immune-complex-type glomerulonephritis. However, myeloperoxidase antineutrophil cytoplasmic antibody (ANCA) was positive, and peritubular capillaritis was observed. Furthermore, citrullinated histone H3-positive neutrophils were detected as markers for neutrophil extracellular trap formation. Therefore, she was diagnosed with ANCA-associated vasculitis superimposed on PSAGN that was the main contributor to her progressive renal injury.

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“…There have been some reports of infectioninduced ANCA-associated vasculitis (AAV). One case report showed that granulomatosis with polyangiitis can be infection-induced [14]. In contrast, PR3-ANCA may appear in association with non-AAV diseases, such as infection, sarcoidosis, and ulcerous colitis [15].…”

Section: Discussionmentioning

confidence: 99%

Infection-Related Cryoglobulinemic Glomerulonephritis with Serum Anti-Factor B Antibodies Identified and Staining for NAPlr/Plasmin Activity Due to Infective Endocarditis

Toishi

Oda

Hamano

et al. 2023

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In this rare case of infection-related cryoglobulinemic glomerulonephritis with infective endocarditis, a 78-year-old male presented with an acute onset of fever and rapidly progressive glomerulonephritis. His blood culture results were positive for Cutibacterium modestum, and transesophageal echocardiography showed vegetation. He was diagnosed with endocarditis. His serum immunoglobulin M, IgM-cryoglobulin, and proteinase-3-anti-neutrophil cytoplasmic antibody levels were elevated, and his serum complement 3 (C3) and C4 levels were decreased. Renal biopsy results showed endocapillary proliferation, mesangial cell proliferation, and no necrotizing lesions on light microscopy, with strong positive staining for IgM, C3, and C1q in the capillary wall. Electron microscopy showed deposits in the mesangial area in the form of fibrous structures without any humps. Histological examination confirmed a diagnosis of cryoglobulinemic glomerulonephritis. Further examination showed the presence of serum anti-factor B antibodies and positive staining for nephritis-associated plasmin receptor and plasmin activity in the glomeruli, suggesting infective endocarditis-induced cryoglobulinemic glomerulonephritis.

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Granulomatosis With Polyangiitis Induced by Infection

Cited by 6 publications

References 9 publications

Glomerular Deposition of Nephritis-Associated Plasmin Receptor (NAPlr) and Related Plasmin Activity: Key Diagnostic Biomarkers of Bacterial Infection-related Glomerulonephritis

Glomerular Deposition of Nephritis-Associated Plasmin Receptor (NAPlr) and Related Plasmin Activity: Key Diagnostic Biomarkers of Bacterial Infection-related Glomerulonephritis

Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis Superimposed on Post-streptococcal Acute Glomerulonephritis

Infection-Related Cryoglobulinemic Glomerulonephritis with Serum Anti-Factor B Antibodies Identified and Staining for NAPlr/Plasmin Activity Due to Infective Endocarditis

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