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Endocapillary proliferative glomerulonephritis in a patient with parvovirus B19 infection
A Komatsuda1, H Ohtani, T Nimura
1Third Department of Internal Medicine, Akita University School of Medicine, and the Department of Internal Medicine, Senboku General Hospital, Akita, Japan.komatsud@med.akita-u.ac.jp
Abstract:
A 45-year-old woman developed acute nephritic syndrome after erythema infectiosum. Laboratory data on admission showed decreased serum C3, C4, and CH50 levels and the presence of both immunoglobulin (Ig) M and IgG antibodies to human parvovirus B19 (HPV). A renal biopsy showed diffuse endocapillary proliferative glomerulonephritis. Immunofluorescence microscopy indicated 2+ granular staining for IgG, IgM, and C3 over the mesangial area and along glomerular capillary walls. HPV antigen was also detected in glomeruli by immunohistochemistry. Electron microscopy showed electron-dense deposits in the subendothelial space and the paramesangial area. These findings suggest that immune complex-type glomerulonephritis is caused by glomerular deposition of HPV antigen-antibody complexes in some patients with HPV infection.
