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Cryoglobulinemic Glomerulonephritis as a Presentation of Atypical Post-Infectious
Glomerulonephritis
#MMPMID26668683
Boumitri C
; Haddad FG
; Rondla C
; El-Sayegh S
; El-Charabaty E
J Clin Med Res
2016[Jan]; 8
(1
): 47-51
PMID26668683
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Post-infectious glomerulonephritis (PIGN) usually occurs within few days to weeks
following an infection. Clinical presentation is variable, but in general, it is
considered a benign entity with good prognosis. It rarely requires kidney biopsy
to confirm the diagnosis. We present a case of a 55-year-old, previously healthy,
male who presented for worsening shortness of breath, persistent cough, and
right-sided pleuritic chest pain. Initial workup revealed a right exudative
effusion with empyema. Hospital course was complicated by acute kidney injury
requiring renal replacement therapy with a peak creatinine of 10.2 mg/dL from a
baseline of 1.18 mg/dL. On kidney biopsy, findings were compatible with a
diagnosis of cryoglobulinemic glomerulonephritis or an atypical form of PIGN.
While a wide variety of histopathological findings on renal biopsies have been
described to complement the usual diffuse proliferative glomerulonephritis
pattern, cryoglobulinemic features with negative cryoglobulin have never been
reported. Our case is unique not only by having an atypical histological
presentation but also by meeting the criteria of atypical PIGN with persistent
hypertension and microscopic hematuria.
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