Anantharaman Ananya, Pandurangan Viswanathan, Srinivasan Devasena, Joyce Divya, Balasubramanian Subalakshmi
General Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Cureus. 2024 Jul 17;16(7):e64769. doi: 10.7759/cureus.64769. eCollection 2024 Jul.
The patterns of infection-related glomerulonephritis (IRGN) are rapidly changing in terms of age at presentation and sources of infection. The existing literature on the use of steroids in IRGN is inconsistent. A diabetic male in his sixties presented with features of anasarca, bilateral flank pain, and acute pulmonary edema. He had a non-healing ulcer over his right leg, with pus culture showing growth of methicillin-resistant (MRSA). Computed tomography (CT) of the kidneys, ureter, and bladder (KUB) showed features of bilateral pyelonephritis. The patient went on to develop acute renal failure and eventually required hemodialysis. A renal biopsy was performed, and features of IRGN with crescents were noted. Considering the presence of crescents in renal biopsy, a trial of steroids was given under antibiotic cover, which resulted in a near-complete resolution of renal failure.
感染相关性肾小球肾炎（IRGN）的发病模式在发病年龄和感染源方面正在迅速变化。关于在IRGN中使用类固醇的现有文献并不一致。一名60多岁的糖尿病男性出现全身水肿、双侧胁腹疼痛和急性肺水肿的症状。他的右腿有一个不愈合的溃疡，脓液培养显示耐甲氧西林金黄色葡萄球菌（MRSA）生长。肾脏、输尿管和膀胱（KUB）的计算机断层扫描（CT）显示双侧肾盂肾炎的特征。患者继而发展为急性肾衰竭，最终需要进行血液透析。进行了肾活检，发现有新月体的IRGN特征。考虑到肾活检中存在新月体，在抗生素覆盖下给予类固醇试验，结果肾衰竭几乎完全缓解。
