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Membranoproliferative glomerulonephritis complicating Propionibacterium acnes infection
Anja Cornér1, Kati Kaartinen1, Sari Aaltonen1
1Department of Nephrology , Helsinki University Central Hospital , Helsinki , Finland.
Background:
Propionibacterium acnes (P. acnes) is a common microbe of the skin and mucosal surfaces rarely considered a true pathogen. However, it has been reported to cause serious infections. Subsequent ongoing low-grade antigenaemia may, in turn, lead to an immune-mediated glomerulonephritis with various renal histologies including that of membranoproliferative glomerulonephritis (MPGN).
Methods:
Here, we describe two cases of P. acnes infection-induced MPGN and their treatment.
Results:
Both patients were successfully treated by the eradication of the infection. One patient also received immunosuppressive medication prior to the correct diagnosis.
Conclusions:
A vigorous exclusion of infection is warranted in MPGN type I or immune-complex-mediated MPGN and may sometimes yield a diagnosis of secondary MPGN.
Insights
Propionibacterium acnes (P. acnes) infection can cause membranoproliferative glomerulonephritis (MPGN). Eradicating the P. acnes infection successfully treated both patients, highlighting the importance of infection screening in MPGN cases.
Area of Science:
- Nephrology
- Infectious Diseases
- Microbiology
Background:
- Propionibacterium acnes (P. acnes), a common skin microbe, is rarely considered pathogenic but can cause severe infections.
- P. acnes infections can lead to chronic low-grade antigenemia, potentially triggering immune-mediated glomerulonephritis.
- Membranoproliferative glomerulonephritis (MPGN) is one of the renal pathologies associated with P. acnes-induced antigenemia.
Purpose of the Study:
- To report two cases of P. acnes infection-induced MPGN.
- To describe the successful treatment of these cases.
- To emphasize the importance of considering infection in MPGN diagnosis.
Main Methods:
- Case report of two patients diagnosed with P. acnes infection-induced MPGN.
- Description of treatment strategies employed for both patients.
- Review of diagnostic considerations for secondary MPGN.
Main Results:
- Both patients achieved successful treatment outcomes following the eradication of P. acnes infection.
- One patient received immunosuppressive therapy before the underlying infection was identified.
Conclusions:
- Infection screening is crucial in cases of MPGN type I or immune-complex-mediated MPGN.
- Identifying and treating secondary infections can lead to resolution of MPGN.
- P. acnes should be considered as a potential trigger for secondary MPGN.
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