Infective Endocarditis-Associated Glomerulonephritis With Cryoglobulin Positivity

Area of Science:

• Nephrology
• Infectious Diseases
• Immunology

Background:

• Serum cryoglobulins are common in infective endocarditis-associated glomerulonephritis (IEAGN).
• Distinguishing IEAGN from primary cryoglobulinemic glomerulonephritis is crucial for effective treatment.

Observation:

• A patient initially diagnosed with cryoglobulinemic glomerulonephritis presented with rapidly declining renal function.
• Renal biopsy findings were consistent with cryoglobulinemic glomerulonephritis, but steroid therapy was ineffective.

Findings:

• Echocardiogram revealed mitral valve vegetation, and blood cultures identified a gram-positive coccus, leading to an IEAGN diagnosis.
• Antimicrobial therapy resulted in normalization of serum cryoglobulins and improved renal function.

Implications:

• Cryoglobulinemia in nephritis necessitates considering IEAGN and differentiating it from other cryoglobulin-associated conditions.
• Successful antimicrobial treatment of IEAGN can resolve associated cryoglobulinemia and improve kidney function.