Update on endocarditis-associated glomerulonephritis

Boils, Christie L.; Nasr, Samih H.; Walker, Patrick D.; Couser, William G.; Larsen, Christopher P.

doi:10.1038/ki.2014.424

Cited by 145 publications

(197 citation statements)

References 45 publications

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“…As with CG, a membranoproliferative-pattern GN with IgG and C3 deposition is the traditional pattern of injury for IE. However, a recent study of clinical specimens demonstrated that IE presented most commonly with crescentic GN, followed by diffuse proliferation, and finally mesangial proliferation without endocapillary proliferation or crescent formation, the latter of which was seen in this case [13]. Confounding this case if the presence of dominant IgM staining in addition to C3.…”

Section: Discussionmentioning

confidence: 52%

A wolf in another wolf’s clothing

Lamba

Kapp

Paueksakon

et al. 2017

IDCases

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This case of infective endocarditis masquerading as mixed cryoglobulinemia in a man with a history of intravenous drug use (IVDU) and hepatitis C virus (HCV) highlights the importance of maintaining a broad differential and continually re-evaluating the working diagnosis as new information presents itself. The patient presented to an outside hospital and was treated for presumptive mixed cryoglobulinemia with corticosteroid therapy. When the patient did not improve, he was transferred to a tertiary care center for possible Rituximab and/or plasmapheresis. Further investigation revealed Enterococcus bacteremia with subsequent workup consistent with infective endocarditis (IE). This case highlights a diagnostic dilemma and demonstrates the importance of a thorough evaluation as it pertains to overlapping features of IE and mixed cryoglobulinemia.

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Section: Discussionmentioning

confidence: 52%

A wolf in another wolf’s clothing

Lamba

Kapp

Paueksakon

et al. 2017

IDCases

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“…3,5,9–11,26,27,47 The presence of c-ANCA in infectious endocarditis is unclear: it may represent a false-positive or related to the infection or the production of c-ANCA may be induced through B-cell activation after release of PR-3 from neutrophils. 43,48 …”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, ANCA positivity was seen in 28% of patients in this cohort. 48 Glomerulonephritis occurs by 2 main immunologic mechanisms: immune complex–mediated and ANCA-associated or pauci-immune. The commonest type of glomerulonephritis is vasculitic, with minimal to absent staining for immunoglobulins by immunofluorescence in 63% to 69% of patients with endocarditis-associated glomerulonephritis.…”

Section: Discussionmentioning

confidence: 99%

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Bartonella Endocarditis and Pauci-Immune Glomerulonephritis

Raybould¹,

Raybould²,

Morales³

et al. 2016

Infect Dis Clin Pract

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Among culture-negative endocarditis in the United States, Bartonella species are the most common cause, with Bartonella henselae and Bartonella quintana comprising the majority of cases. Kidney manifestations, particularly glomerulonephritis, are common sequelae of infectious endocarditis, with nearly half of all Bartonella patients demonstrating renal involvement. Although a pauci-immune pattern is a frequent finding in infectious endocarditis–associated glomerulonephritis, it is rarely reported in Bartonella endocarditis. Anti–neutrophil cytoplasmic antibody (ANCA) positivity can be seen with many pathogens causing endocarditis and has been previously reported with Bartonella species. In addition, ANCA-associated vasculitis can also present with renal and cardiac involvement, including noninfectious valvular vegetations and pauci-immune glomerulonephritis. Given the overlap in their clinical presentation, it is difficult to differentiate between Bartonella endocarditis and ANCA-associated vasculitis but imperative to do so to guide management decisions. We present a case of ANCA-positive Bartonella endocarditis with associated pauci-immune glomerulonephritis that was successfully treated with medical management alone.

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“…Les principales pathologies responsables de GnRP observées en réanimation sont les vascularites associées aux ANCA, la maladie de Goospasture, le lupus et les glomérulo-néphrites associées aux foyers infectieux profonds, qui compliquent le plus souvent l'évolution des endocardites [11].…”

Section: Glomérulonéphrites Rapidement Progressives (Gnrp)unclassified

Stratégie diagnostique de l’insuffisance rénale aiguë en réanimation

et al. 2015

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L'insuffisance rénale aiguë (IRA) en réanimation est une entité fréquente, qui s'intègre souvent dans un contexte d'agression rénale aiguë, dont les états de choc sont les principaux pourvoyeurs. Toutefois, l'IRA en réanimation peut être le symptôme d'une pathologie sous-jacente spécifique, dont le diagnostic et la prise en charge représentent un enjeu conditionnant le pronostic fonctionnel et vital du patient. L'objectif de cette revue est de présenter au praticien les différentes étiologies d'IRA en réanimation, avec leurs caracté-ristiques épidémiologiques, cliniques et paracliniques, ainsi que les moyens à sa disposition pour construire sa démarche diagnostique, en discutant leur validité chez le patient agressé de réanimation. L'anamnèse est une étape majeure de la réflexion clinique face à une IRA en réanimation ne s'inté-grant pas dans le concept d'agression rénale aiguë. Enfin, la place et les indications de la ponction-biopsie rénale chez le patient de réanimation seront discutées. Mots clés Insuffisance rénale aiguë · Réanimation · DiagnosticAbstract In the intensive care unit (ICU), most patients with high level of serum creatinine are now considered to have acute kidney injury (AKI). AKI results from several systemic aggressors such as sepsis, shock, or nephrotoxic drug. However, this may not be true in all patients. Indeed some ICU patients may suffer from a more specific form of acute renal failure. Prompt diagnosis and treatment are crucial for the prognosis of these patients. The aim of this article is to present an overview of renal failure that can be encountered in the ICU setting. It also aims at suggesting a diagnostic strategy taking into account the specificity of the ICU patients. Finally, the indications of renal biopsy in the critically ill patients are discussed.

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Update on endocarditis-associated glomerulonephritis

Cited by 145 publications

References 45 publications

A wolf in another wolf’s clothing

A wolf in another wolf’s clothing

Bartonella Endocarditis and Pauci-Immune Glomerulonephritis

Stratégie diagnostique de l’insuffisance rénale aiguë en réanimation

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