Rapidly Progressive Glomerulonephritis Concomitant with Diabetic Nephropathy.

Kitazawa, Mitsutaka; Tomosugi, Naohisa; Ishii, Takashi; Hotta, Fumitake; Nishizawa, Makoto; Itou, Tomohiko; Nakano, Shigeru; Kigoshi, Toshikazu; Ishikawa, Isao; Uchida, Kenzo

doi:10.2169/internalmedicine.36.906

Cited by 8 publications

(5 citation statements)

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“…Typical PIGN is commonly characterized by glomerular granular deposition of C3 and IgG or C3 only by immunofluorescence and occasionally with IgM in PIGN. 3 Conversely, immune-complex deposits in human glomerulonephritis related to staphylococcal infection are typically IgA-dominant or C3-dominant rather than IgG-dominant granular deposition in capillary walls detected using IF, 2 , 4 , 9 especially in older patients with diabetes. Seldom, patients have characteristic subepithelial “hump-shaped” electron-dense deposits found in typical PIGN by EM.…”

Section: Discussionmentioning

confidence: 99%

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Clinical, Pathological, and Prognostic Characteristics of Glomerulonephritis Related to Staphylococcal Infection

Wang

Zhang

et al. 2016

Medicine

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Staphylococcal infection has become a common cause of postinfectious glomerulonephritis in the past 3 decades. Because few investigations focus on this disease, the demographics and clinicopathological features of glomerulonephritis related to staphylococcal infection are not well characterized.We conducted a pooled analysis of published literature in electronic databases and analyzed the clinical features, laboratory findings, and histopathological changes. The patients were divided into 4 groups based on their prognosis: remission, persistent renal dysfunction, end-stage renal disease (ESRD), or death. A logistic regression model was used to identify the determinants of disease outcome.A total of 83 (64 men) patients with glomerulonephritis related to staphylococcal infection from 31 reports were analyzed. The mean age was 58 years (58 ± 17). Majority of the reports originated from Taiwan, Japan, and the United States. Clinical characteristics of the cases were hematuria (82/83), proteinuria (78/83), and acute kidney injury (75/83). Visceral abscesses (26/83) and skin infections (24/83) were the common sites of infection. Methicillin-resistant Staphylococcus aureus was the most common pathogen. The dominant or codominant deposition of IgA or C3 along the glomeruli was an important feature identified by immunofluorescence. There were 19 patients (22.9%) that progressed to dialysis-dependent ESRD. Twelve patients (14.5%) died. A univariate regression analysis indicated that diabetes mellitus (DM) (odds ratio [OR] 2.96; 95% confidence interval [CI] 1.03–8.48; P = 0.04) and age (OR 4.80; 95% CI 1.84–12.53; P = 0.001) were risk factors for ESRD or death. A multivariate regression analysis also revealed that age (OR 4.90; 95% CI 1.82–13.18; P = 0.002) and DM (OR 3.07; 95% CI 0.98–9.59; P = 0.05) were independent risk factors for unfavorable prognosis.Glomerulonephritis related to staphylococcal infection has different features than typical postinfectious glomerulonephritis. The diagnosis of glomerulonephritis related to staphylococcal infection relies on immunofluorescence and electron microscopy findings. Age and DM are independent risk factors of poor prognosis for glomerulonephritis related to staphylococcal infection.

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Section: Discussionmentioning

confidence: 99%

“…One study was excluded because the patients had nephropathy combined with infection. 9 Six references were excluded because of publication type (ie, review). 5 , 10 – 14 Seventeen studies were also excluded due to unavailable original demographic and clinicopathological data.…”

Section: Methodsmentioning

confidence: 99%

Clinical, Pathological, and Prognostic Characteristics of Glomerulonephritis Related to Staphylococcal Infection

Wang

Zhang

et al. 2016

Medicine

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“…In this case, we initially thought the patient had crescentic GN superimposed on DN because of the marked extra-capillary hypercellularity. There are several reports of DN complicated by crescentic GN, such as ANCA-associated nephritis [ 4 , 5 ]. On the other hand, there are also reports of DN with crescent formation [ 4 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

Diabetic nephropathy with marked extra-capillary cell proliferation: a case report

et al. 2023

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Background Extra-capillary hypercellularity is a common finding in crescentic glomerulonephritis (GN) and focal segmental glomerulosclerosis (FSGS). In diabetic nephropathy (DN), extra-capillary hypercellularity is often observed as a finding of complications such as IgA nephropathy or microscopic polyangiitis superimposed on DN. However, in rare cases, epithelial cell proliferation may accompany DN. We experienced a case of nodular diabetic glomerulosclerosis with marked extra-capillary hypercellularity and revealed the origin of this atypical lesion using immunostainings. Case presentation A man in his 50 s was admitted to the hospital with nephrotic syndrome, and a renal biopsy was performed. Diffuse nodular lesions and extra-capillary hypercellularity were observed, but the results of serological examination or immunofluorescent assays did not implicate any other crescentic GN. Immunostaining for claudin-1 and nephrin was performed to identify the origin of the extra-capillary lesions. Given the clinical course and pathological findings, a diagnosis of DN-associated extra-capillary cell proliferation was made. Conclusions Extra-capillary hypercellularity, which resembles FSGS or crescentic GN, is a rare finding in DN and should therefore be treated with caution. In such cases, co-staining for claudin-1 and nephrin may facilitate the diagnosis of DN.

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“…In this case, we initially thought the patient had crescentic GN superimposed on DN because of the marked extra-capillary hypercellularity. There are several reports of DN complicated by crescentic GN, such as ANCA-associated nephritis [4,5]. On the other hand, there are also reports of DN with crescent formation [4, [9].…”

Section: Discussionmentioning

confidence: 99%

Diabetic nephropathy with marked extra-capillary cell proliferation: A case report

Morimoto

Namba‐Hamano

Notsu

et al. 2023

Preprint

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Background: Extra-capillary hypercellularity is a common finding in crescentic glomerulonephritis (GN) and focal segmental glomerulosclerosis (FSGS). In diabetic nephropathy (DN), extra-capillary hypercellularity is often observed as a finding of complications such as IgA nephropathy or microscopic polyangiitis superimposed on DN. However, in rare cases, epithelial cell proliferation may accompany DN. We experienced a case of nodular diabetic glomerulosclerosis with marked extra-capillary hypercellularity and revealed the origin of this atypical lesion using immunostainings. Case presentation: A man in his 50s was admitted to the hospital with nephrotic syndrome, and a renal biopsy was performed. Diffuse nodular lesions and extra-capillary hypercellularity were observed, but the results of serological examination or immunofluorescent assays did not implicate any other crescentic GN. Immunostaining for claudin-1 and nephrin was performed to identify the origin of the extra-capillary lesions. Given the clinical course and pathological findings, a diagnosis of DN-associated extra-capillary cell proliferation was made. Conclusions: Extra-capillary hypercellularity, which resembles FSGS or crescentic GN, is a rare finding in DN and should therefore be treated with caution. In such cases, co-staining for claudin-1 and nephrin may facilitate the diagnosis of DN.

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Rapidly Progressive Glomerulonephritis Concomitant with Diabetic Nephropathy.

Cited by 8 publications

References 0 publications

Clinical, Pathological, and Prognostic Characteristics of Glomerulonephritis Related to Staphylococcal Infection

Clinical, Pathological, and Prognostic Characteristics of Glomerulonephritis Related to Staphylococcal Infection

Diabetic nephropathy with marked extra-capillary cell proliferation: a case report

Diabetic nephropathy with marked extra-capillary cell proliferation: A case report

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