Acute disseminated encephalomyelitis and poststreptococcal acute glomerulonephritis

Area of Science:

• Neurology
• Nephrology
• Infectious Diseases

Background:

• Acute disseminated encephalomyelitis (ADEM) is a rare, immune-mediated inflammatory disease of the central nervous system.
• Acute glomerulonephritis (AGN) is kidney inflammation often caused by infections, notably Streptococcus pyogenes.
• Concurrent presentation of ADEM and AGN is exceptionally uncommon.

Observation:

• A pediatric patient presented with symptoms of both ADEM and AGN.
• Magnetic resonance imaging (MRI) revealed multiple brain lesions primarily in the cortical gray matter.
• Renal biopsy confirmed poststreptococcal acute glomerulonephritis.

Findings:

• The patient's neurological symptoms and brain lesions showed a rapid positive response to intravenous methylprednisolone pulse therapy.
• Throat culture and serological tests confirmed Streptococcus pyogenes infection.
• The clinical course suggested a coincidental occurrence of S. pyogenes infection triggering both ADEM and AGN.

Implications:

• This case highlights the importance of considering infectious triggers for neurological and renal inflammatory conditions.
• The prompt response to immunosuppressive therapy in ADEM suggests an autoimmune component.
• Further research may elucidate the potential link between Streptococcus pyogenes infections and the development of ADEM alongside AGN.