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Crescentic Glomerulonephritis Associated with Pulmonary Tuberculosis.
K V Kanodia1, A V Vanikar2, R D Patel1
1Professor, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India .
Journal of Clinical and Diagnostic Research : JCDR
|February 20, 2016
Summary
Tuberculosis can rarely affect the kidneys, causing rapidly progressive glomerulonephritis. This case highlights a rare presentation of kidney tuberculosis and its challenging treatment in a young man.
Area of Science:
- Nephrology
- Infectious Diseases
- Pathology
Background:
- Tuberculosis of the kidney and urinary tract is caused by Mycobacterium tuberculosis complex.
- Renal infection typically occurs via hematogenous spread from a pulmonary focus.
- Glomerular involvement presenting as rapidly progressive glomerulonephritis is a rare manifestation of tuberculosis.
Observation:
- A 26-year-old man presented with crescentic glomerulonephritis and pulmonary tuberculosis.
- The patient underwent treatment with corticosteroids, hemodialysis, intravenous immunoglobulin, and plasmapheresis.
- Initial anti-tuberculosis treatment for renal pathology was ineffective.
Findings:
- The patient required maintenance hemodialysis due to lack of response to anti-tuberculosis therapy for the renal disease.
- Pulmonary tuberculosis showed a positive response to treatment.
- This case illustrates a rare association between pulmonary tuberculosis and crescentic glomerulonephritis.
Implications:
- Highlights the diagnostic and therapeutic challenges of renal tuberculosis presenting as glomerulonephritis.
- Suggests that renal tuberculosis should be considered in patients with unexplained rapidly progressive glomerulonephritis, especially in endemic areas.
- Emphasizes the need for tailored treatment strategies for renal tuberculosis-associated glomerulonephritis.
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