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[Glomerulonephritis secondary to ventriculo-atrial shunts]
Annales De Medecine Interne
|January 1, 1985
Summary
A patient with a ventriculo-atrial shunt developed nephrotic syndrome and sepsis due to Corynebacterium commensale and Staphylococcus epidermis. Valve removal led to clinical cure, highlighting the shunt as a source of infection.
Area of Science:
- Nephrology
- Infectious Diseases
- Neurosurgery
Background:
- Normal pressure hydrocephalus (NPH) management often involves ventriculo-atrial cerebrospinal fluid (CSF) shunts.
- CSF shunts can be a source of recurrent infections and systemic complications.
Observation:
- A 45-year-old male with a 5-year-old ventriculo-atrial shunt presented with recurrent infections, sepsis, and nephrotic syndrome.
- Infection of the shunt valve by Corynebacterium commensale and Staphylococcus epidermis was identified.
- Renal biopsy revealed type I proliferative glomerulonephritis with subendothelial immune deposits.
Findings:
- Shunt removal resulted in clinical resolution of sepsis and nephrotic syndrome with preserved renal function.
- Evidence suggested activation of the alternate complement pathway and circulating immune complexes in pathogenesis.
- Histopathology indicated immune-mediated glomerulonephritis potentially triggered by chronic infection.
Implications:
- Ventriculo-atrial shunts can lead to severe systemic complications, including nephrotic syndrome.
- Prompt diagnosis and management of shunt infections are crucial for patient outcomes.
- This case underscores the importance of considering shunt-related infections in patients with unexplained sepsis and nephrotic syndrome.