Streptococcal Infection-related Nephritis (SIRN) Manifesting Membranoproliferative Glomerulonephritis Type I

Ken Iseri; Masayuki Iyoda; Yasutaka Yamamoto; Naoto Kobayashi; Takashi Oda; Yutaka Yamaguchi; Takanori Shibata

doi:10.2169/internalmedicine.55.5409

CASE REPORTS

Streptococcal Infection-related Nephritis (SIRN) Manifesting Membranoproliferative Glomerulonephritis Type I

Ken Iseri, Masayuki Iyoda, Yasutaka Yamamoto, Naoto Kobayashi, Takashi Oda, Yutaka Yamaguchi, Takanori Shibata

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Keywords: membranoproliferative glomerulonephritis (MPGN), nephritis-associated plasmin receptor (NAPlr), post-streptococcal acute glomerulonephritis (PSAGN), streptococcal infection-related nephritis (SIRN), nephrotic syndrome

JOURNAL OPEN ACCESS

2016 Volume 55 Issue 6 Pages 647-650

DOI https://doi.org/10.2169/internalmedicine.55.5409

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Abstract

We herein report the case of an 18-year-old boy who developed nephrotic syndrome and hypertension after upper airway inflammation. Post-streptococcal acute glomerulonephritis was diagnosed on the basis of a high antistreptolysin O titer, hypocomplementemia, proteinuria, and microscopic hematuria. A renal biopsy was performed due to persistent proteinuria, and the pathological diagnosis was membranoproliferative glomerulonephritis (MPGN) type I. Glomeruli showed positive staining for nephritis-associated plasmin receptor (NAPlr), a nephritogenic group A streptococcal antigen, and plasmin activity was found in a similar distribution as NAPlr deposition. This rare case of streptococcal infection-related nephritis (SIRN) manifesting MPGN type I supports the histological diversity of SIRN.

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