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[Acute renal failure following Chlamydia pneumoniae pneumonia in a child]

H Nasser1, G Dib Nehme, M-C Camoin-Schweitzer

  • 1Unité de néphrologie et de dialyse pédiatrique, médecine infantile I, hôpital d'Enfants, CHU de Nancy, Nancy, France. drhnasser@hotmail.com

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|June 15, 2010
PubMed

Insights

Acute kidney injury following Chlamydia pneumoniae pneumonia is uncommon in children. This case highlights tubulointerstitial nephropathy as a potential complication of this infection, emphasizing early diagnosis and macrolide treatment for favorable outcomes.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Pulmonology

Background:

  • Acute renal failure (ARF) is a rare complication of Chlamydia pneumoniae pneumonia in adults.
  • Community-acquired pneumonia requires consideration of diverse etiologies, including atypical pathogens.
  • Tubulointerstitial nephropathy can manifest with various clinical and laboratory abnormalities.

Observation:

  • A 10-year-old child developed symptoms of renal dysfunction, including asthenia, polyuria, and polydipsia, after completing a 10-day course of roxithromycin for C. pneumoniae pneumonia.
  • The child presented with elevated plasma creatinine, metabolic acidosis, hypokalemia, and tubular damage markers, with no concurrent use of nephrotoxic drugs.
  • Diagnostic workup revealed positive C. pneumoniae antibodies and elevated complement (C3, C4) and immunoglobulin (IgA, IgG) levels, with no evidence of uveitis.

Findings:

  • The patient was diagnosed with tubulointerstitial nephropathy secondary to Chlamydia pneumoniae pneumonia.
  • C. pneumoniae pneumonia can be associated with tubulointerstitial nephropathy and/or rapidly progressive glomerulonephritis in both children and adults.
  • The severity of renal involvement in C. pneumoniae infections can vary significantly.

Implications:

  • Chlamydia pneumoniae pneumonia should be considered in the differential diagnosis of community-acquired pneumonia, particularly in cases with poor treatment response.
  • Early recognition and prompt treatment with macrolide antibiotics are crucial for managing C. pneumoniae-associated renal complications.
  • Timely intervention typically leads to favorable recovery of renal function in pediatric patients.

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