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Published on: October 5, 2015
Mesangiocapillary glomerulonephritis complicating pulmonary tuberculosis
Paul Torpiano1, Stephen Holwill2, David Pace3
1Department of Paediatrics and Adolescent Health, Mater Dei Hospital, Msida, MSD2090, Malta. paul.torpiano@gov.mt.
Tuberculosis can cause mesangiocapillary glomerulonephritis (MCGN) in adolescents, often presenting with nephrotic-range proteinuria. Early diagnosis and treatment of this kidney complication are crucial to prevent chronic kidney disease.
Area of Science:
- Nephrology
- Infectious Diseases
- Immunology
Background:
- Glomerulonephritis associated with tuberculosis can stem from direct renal infection or immune-complex deposition secondary to extra-renal tuberculosis.
- Pulmonary tuberculosis is a common extra-renal manifestation that can trigger renal complications.
Observation:
- A 17-year-old male with pulmonary tuberculosis developed nephrotic-range proteinuria and edema shortly after initiating anti-tuberculous therapy.
- Renal biopsy confirmed mesangiocapillary glomerulonephritis (MCGN) with immune deposits and podocyte effacement, indicating an immune-mediated process.
Findings:
- The patient received a combination of corticosteroids and anti-tuberculous drugs, leading to clinical improvement.
- Despite treatment, persistent heavy proteinuria necessitated the initiation of enalapril to manage the renal condition.
Implications:
- This case underscores the association between tuberculosis and MCGN in adolescents, emphasizing the need for vigilance.
- Prompt identification and management of tuberculosis-related glomerulonephritis are vital for preventing the progression to chronic kidney disease.
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