Mixed cryoglobulinemia and secondary membranoproliferative glomerulonephritis associated with ehrlichiosis

Caster, Dawn J.; Summersgill, James T.; Paueksakon, Paisit; Massung, Robert F.; Shieh, Wun‐Ju; McLeish, Kenneth R.

doi:10.1007/s13730-014-0113-6

Cited by 5 publications

(8 citation statements)

References 23 publications

(25 reference statements)

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“…Three other proteinuric A‐CKD or CKD dogs were diagnosed with concurrent pancreatitis, which could have contributed, in part, to the proteinuria. Ehrlichia is considered a potential etiological agent for glomerular disease that may induce glomerular injury secondary to immune complex deposition . Membranoproliferative glomerulonephritis was reported in a human infected with E. chaffeensis .…”

Section: Discussionmentioning

confidence: 99%

“…Ehrlichia is considered a potential etiological agent for glomerular disease that may induce glomerular injury secondary to immune complex deposition . Membranoproliferative glomerulonephritis was reported in a human infected with E. chaffeensis . Dogs experimentally infected with E. canis developed transient proteinuria, increased UP/C, and hypoalbuminemia with glomerular deposition of immune complexes .…”

Section: Discussionmentioning

confidence: 99%

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Clinicopathological findings in 41 dogs (2008‐2018) naturally infected withEhrlichia ewingii

Qurollo

Buch

Chandrashekar

et al. 2019

Veterinary Internal Medicne

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Background Ehrlichia ewingii is the most seroprevalent Ehrlichia‐infecting dogs in the southern and mid‐western United States. Fever, lameness, and polyarthritis are commonly reported findings in dogs naturally infected with E. ewingii. Objectives To evaluate clinicopathologic findings in a population of dogs naturally infected with E. ewingii. Animals Forty‐one dogs PCR positive for E. ewingii and PCR negative for other targeted vector‐borne organisms. Methods Retrospective study. Clinical and clinicopathologic data including physical examination findings, CBC, serum biochemistry, urinalysis (UA), symmetric dimethylarginine (SDMA), and vector‐borne disease diagnostic results were reviewed. Results Frequent clinical diagnoses other than ehrlichiosis (28/41; 68.3%) were renal disease (7/41; 17.1%) and immune‐mediated hemolytic anemia (IMHA) (6/41; 14.6%). The most frequent physical examination finding was joint pain (14/41; 34.1%). Prominent hematologic and biochemical abnormalities included abnormal lymphocyte counts (22/36; 61.1%); neutrophilia (21/37; 56.8%); increased alkaline phosphatase (20/35; 57.1%) and alanine transaminase (14/35; 40%) activities; and increased SDMA concentration (11/34; 32.4%). Urinalysis abnormalities included proteinuria (20/27; 74%), most with inactive sediments (16/20; 80%). Dogs were seroreactive by Ehrlichia canis immunofluorescence assay (IFA; 17/39; 43.6%) and Ehrlichia ELISA (34/41; 82.9%). Seroreactivity by IFA for other vector‐borne pathogens included Bartonella (1/39; 2.6%), Rickettsia rickettsii (spotted‐fever group rickettsiae) (12/39; 30.8%), and Borrelia burgdorferi by ELISA (1/41; 2.4%). Conclusions and Clinical Importance Renal disease, IMHA, proteinuria, neutrophilia, abnormal lymphocytes, and increased liver enzyme activities were common in this group of E. ewingii‐infected dogs. Studies are needed to determine if E. ewingii contributes to comorbidities or is a precipitating factor in clinical syndromes in persistently infected dogs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinicopathological findings in 41 dogs (2008‐2018) naturally infected withEhrlichia ewingii

Qurollo

Buch

Chandrashekar

et al. 2019

Veterinary Internal Medicne

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“…He did not demonstrate the common finding of thrombocytopenia. Nephrotic syndrome has been described in patients with Ehrlichiosis [2,3]. Our patient demonstrated an initial clinical improvement on Doxycycline however this was later stopped when the diagnosis of SLE was made.…”

Section: Disscussionmentioning

confidence: 55%

Brief Report: False Positive Erlichia Serology in a Patient with SLE (Systemic Lupus Erythematosus).

Bergamo¹,

Campos²

2021

Journal of Multidisciplinary Clinical Case Reports

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Systemic Lupus Erythematosus (SLE) and Ehrlichiosis may present with similar history and physical findings; therefore, tick borne disease must be considered in endemic areas. Symptoms include: myalgia, nausea, anorexia, fever and a maculopapular to petechial rash. Laboratory findings include leukopenia, hyponatremia, elevated liver enzymes, anemia and thrombocytopenia. Nephritic syndrome has been described in patients with Ehrlichiosis.

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“…Despite the histopathological evidence of nephron damage seen in previous studies [ 13 – 15 ], the literature related to the detection of subclinical AKI in dogs with CME by non-invasive assays is limited. The aim of this prospective clinical study was to evaluate the concentrations of functional renal biomarkers and the novel urinary biomarkers of active kidney injury, urinary cystatin B (uCysB) and urinary clusterin (uClust), in dogs naturally infected with E .…”

Section: Introductionmentioning

confidence: 99%

“…canis also causes a pro-inflammatory state that promotes periglomerular edema resulting from cell extravasation. The subsequent accumulation of immune complexes in the mesangium and glomerular tufts, as well as podocyte fusion and focal necrosis, leads to proteinuria, with a substantial increase in urine protein: creatinine ratio concentrations (UPC) and a decrease in GFR [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Novel renal injury markers in dogs with ehrlichiosis

Le Sueur,

de Souza,

Paes

et al. 2023

PLoS ONE

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Canine monocytic ehrlichiosis (CME) has been observed to impact renal function. Currently, the recognition of acute kidney injury is through the nonspecific biomarker serum creatinine (sCr). Novel markers of renal injury such as urinary clusterin (uClust) and urinary cystatin B (uCysB) may increase our understanding of the relationship between ehrlichiosis and renal cellular injury. The aim of this study was to evaluate novel renal injury biomarkers in dogs with acute CME. Twenty healthy dogs were enrolled in the control group (CG), and 16 dogs naturally infected with Ehrlichia canis were included in the Ehrlichia Group (EG). All dogs were followed for 45 days. EG dogs were treated with doxycycline twice daily for the first 30 days. Urine and serum were collected at: 0, 0.5, 1, 15, 30, and 45 days after start of treatment. Urine concentrations of uClust and uCysB were determined using a research ELISA immunoassay. A linear mixed model was used to estimate population mean of renal injury markers with patient as the random effect, and day and treatment as fixed effects. EG was observed to have higher uClust values compared to CG (estimated population mean EG: 213 ng/dL vs. CG: 84 ng/dL, P < 0.001). EG was observed to have higher uCysB values compared to CG (estimated population mean EG: 248 ng/dL vs. CG: 38 ng/dL, P < 0.001). Increases in uCysB and uClust suggest the presence of renal injury and a possible mechanism for the observed predisposition to chronic kidney disease in dogs with ehrlichiosis.

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Mixed cryoglobulinemia and secondary membranoproliferative glomerulonephritis associated with ehrlichiosis

Cited by 5 publications

References 23 publications

Clinicopathological findings in 41 dogs (2008‐2018) naturally infected withEhrlichia ewingii

Clinicopathological findings in 41 dogs (2008‐2018) naturally infected withEhrlichia ewingii

Brief Report: False Positive Erlichia Serology in a Patient with SLE (Systemic Lupus Erythematosus).

Novel renal injury markers in dogs with ehrlichiosis

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