Ng Camille, Penney Angela, Sharaflari Rojin, Pathak Akash, Howard Iii John H, Jen Kuang-Yu
College of Medicine California Northstate University, Elk Grove, CA, USA.
Capital Nephrology Medical Group, Sacramento, CA, USA.
Case Rep Nephrol. 2024 Sep 6;2024:4181660. doi: 10.1155/2024/4181660. eCollection 2024.
Kidney complications can occur due to infective endocarditis, one of which is glomerulonephritis. Most often, an immune complex or complement-mediated glomerulonephritis is seen on kidney biopsy. In a minor subset of cases, pauci-immune glomerulonephritis may be present. Most often, such patients will demonstrate the presence of antineutrophil cytoplasmic antibodies (ANCA) on serologic testing. A growing number of cases of ANCA-associated glomerulonephritis due to Bartonella endocarditis have been reported. This type of endocarditis can present diagnostic difficulties given that these patients are often culture negative. Herein, we report a challenging case of ANCA-negative pauci-immune glomerulonephritis showing florid crescents on biopsy that was associated with Bartonella endocarditis.
感染性心内膜炎可导致肾脏并发症，其中之一是肾小球肾炎。在肾活检中，最常见的是免疫复合物或补体介导的肾小球肾炎。在一小部分病例中，可能存在寡免疫性肾小球肾炎。这类患者在血清学检测中通常会显示抗中性粒细胞胞浆抗体（ANCA）阳性。越来越多由巴尔通体心内膜炎引起的ANCA相关性肾小球肾炎病例被报道。鉴于这些患者的血培养往往为阴性，这种类型的心内膜炎可能会带来诊断困难。在此，我们报告一例具有挑战性的ANCA阴性寡免疫性肾小球肾炎病例，其活检显示有大量新月体形成，且与巴尔通体心内膜炎相关。
