Takata Tomoaki, Mae Yukari, Sugihara Takaaki, Isomoto Hajime
Division of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan.
Yonago Acta Med. 2022 Jan 28;65(1):1-7. doi: 10.33160/yam.2022.02.011. eCollection 2022 Feb.
A significant proportion of patients with infective endocarditis presents with acute renal failure related to infective endocarditis-associated glomerulonephritis (IEAGN). However, the clinical presentation of IEAGN differs from that of other infection-related glomerulonephritis (IRGN) with anti-neutrophil cytoplasmic antibody (ANCA) positivity occurring in almost one-third of cases; therefore, it may be difficult to establish a definitive diagnosis and provide appropriate treatment. This review article provides a comprehensive understanding of the clinical presentation, investigations, histopathology, and treatment/management of IEAGN so that clinicians can keep this differential in mind for patients with fever of unknown origin accompanied by signs and symptoms of acute renal failure.
相当一部分感染性心内膜炎患者会出现与感染性心内膜炎相关肾小球肾炎(IEAGN)相关的急性肾衰竭。然而,IEAGN的临床表现与其他感染相关肾小球肾炎(IRGN)不同,近三分之一的病例中会出现抗中性粒细胞胞浆抗体(ANCA)阳性;因此,可能难以做出明确诊断并提供适当治疗。这篇综述文章全面介绍了IEAGN的临床表现、检查、组织病理学以及治疗/管理,以便临床医生在遇到不明原因发热并伴有急性肾衰竭体征和症状的患者时能够考虑到这种鉴别诊断。