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Báo cáo khoa học: " Post-infection immunocomplex glomerulonephritis and Legionnaires’ disease in a patient with adult Still’s disease during treatment with interleukin 1 receptor antagonist anakinra: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Post-infection immunocomplex glomerulonephritis and Legionnaires’ disease in a patient with adult Still’s disease during treatment with interleukin 1 receptor antagonist anakinra: a case report. | Scholtze et al. Journal of Medical Case Reports 2011 5 299 http www.jmedicalcasereports.eom content 5 1 299 WV journalof medical l rCASE REPORTS CASE REPORT Open Access Post-infection immunocomplex glomerulonephritis and Legionnaires disease in a patient with adult Still s disease during treatment with interleukin 1 receptor antagonist anakinra a case report Dieter Scholtze1 Zsuzsanna Varga2 and Alexander Imhof1 Abstract Introduction Legionellosis is a systemic disease that primarily affects the lungs. However dysfunction in many organ systems including the kidneys has also been described. There are only a few reported cases of renal dysfunction in patients with legionellosis. Case presentation A 27-year-old Caucasian woman with known adult Still s disease was admitted to our hospital for community-acquired pneumonia due to Legionella infection with acute renal failure. Although her respiratory symptoms responded well to antibiotic treatment her renal function worsened with severe proteinuria and edema. A renal biopsy showed extracapillary and endocapillary proliferative glomerulonephritis with accompanying chronic and acute interstitial nephritis. This was consistent with a post-infection immunocomplex glomerulonephritis. After initiation of steroid therapy her renal function improved. Additionally therapy with diuretics and an angiotensin-converting enzyme inhibitor was initiated because of persistent proteinuria. Under this treatment regimen her severe edema and proteinuria disappeared. Conclusion To the best of our knowledge there is only a handful of reported cases of post-infection glomerulonephritis with a nephrotic syndrome in a patient with legionellosis. Our findings suggest that in patients with Legionnaires disease with renal failure post-infection immunocomplex glomerulonephritis should be considered and steroid therapy may be an effective modality to treat the renal complication. Introduction Legionellosis is a systemic disease that primarily affects