Acute infection-related glomerulonephritis with disseminated gonococcal infection in a 13-year-old girl

BMJ Case Rep. 2018 Jul 18:2018:bcr2018225371. doi: 10.1136/bcr-2018-225371.

Abstract

Infection-related glomerulonephritis results from glomerular immune complex deposition due to a variety of potential pathogens. Poststreptococcal glomerulonephritis is the best known example. We present a case of acute infection-related glomerulonephritis associated with disseminated gonococcal infection in a sexually active 13-year-old girl, the first report of such an association in the absence of endocarditis. The patient presented with features of acute disseminated gonococcal infection including fever, hypotension, tenosynovitis, polyarthralgias and petechiae. She developed hypocomplementemic glomerulonephritis synchronous with the acute infection. The renal biopsy revealed a diffuse endocapillary proliferative and exudative glomerulonephritis with subepithelial electron-dense humps and granular glomerular capillary wall staining for C3 and IgG, typical of acute postinfectious glomerulonephritis. After treatment and resolution of the gonococcal infection, the serum creatinine, complement levels and urine sediment normalised. The only residual renal damage 16 months later was low-grade proteinuria.

Keywords: immunology; infections; renal system.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adolescent
  • Amlodipine / administration & dosage
  • Anti-Bacterial Agents / administration & dosage
  • Antihypertensive Agents / administration & dosage
  • Biopsy
  • Ceftriaxone / administration & dosage
  • Creatine / blood
  • Doxycycline / administration & dosage
  • Female
  • Glomerulonephritis / drug therapy
  • Glomerulonephritis / etiology*
  • Gonorrhea / complications*
  • Gonorrhea / drug therapy
  • Humans
  • Kidney Glomerulus*
  • Neisseria gonorrhoeae / isolation & purification

Substances

  • Anti-Bacterial Agents
  • Antihypertensive Agents
  • Amlodipine
  • Ceftriaxone
  • Creatine
  • Doxycycline