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Nephritis-Associated Plasmin Receptor-Positive Post-Streptococcal Acute Glomerulonephritis Showing Full-House
Yusuke Takahashi1, Naoto Kawata1, Hiroki Nishiwaki1,2
1Division of Nephrology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan.
Case Reports in Nephrology and Dialysis
|October 9, 2025
Summary
Post-streptococcal acute glomerulonephritis (PSAGN) can present with challenging diagnostic features. Identifying nephritis-associated plasmin receptor (NAPlr) aids in diagnosing infection-related glomerulonephritis.
Area of Science:
- Nephrology
- Immunology
- Pathology
Background:
- Post-streptococcal acute glomerulonephritis (PSAGN) is a common cause of nephritic syndrome following streptococcal infections.
- PSAGN diagnosis can be challenging due to nonspecific pathological findings and overlapping clinical presentations.
Purpose of the Study:
- To present a challenging case of PSAGN with acute kidney injury and nephrotic syndrome.
- To highlight the utility of nephritis-associated plasmin receptor (NAPlr) staining in diagnosing infection-related glomerulonephritis.
Main Methods:
- Case report of a 25-year-old male with PSAGN.
- Diagnostic workup included serological tests (ASO, C3), kidney biopsy with light microscopy, immunofluorescence, and electron microscopy.
- Glomerular staining for NAPlr and plasmin activity was performed.
Main Results:
- The patient presented with edema, cough, nephrotic syndrome, severe kidney dysfunction, and hematuria.
- Biopsy showed membranoproliferative glomerulonephritis with a full-house pattern and subendothelial deposits.
- Positive glomerular staining for NAPlr and plasmin activity supported an infection-related etiology.
- Treatment with corticosteroids led to resolution of hematuria.
Conclusions:
- Nonspecific pathological findings in PSAGN can pose diagnostic difficulties.
- Nephritis-associated plasmin receptor (NAPlr) staining is a valuable tool for diagnosing infection-related glomerulonephritis when other diagnoses are uncertain.
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