Immune complex-mediated membranoproliferative glomerulonephritis following scabies infestation in a child: a rare...

Scabies, caused by Sarcoptes scabiei var. hominis, is a common parasitic infestation in tropical regions. Although primarily dermatological, it can rarely trigger systemic complications such as immune complex-mediated membranoproliferative glomerulonephritis (MPGN). A 14-year-old boy presented with bilateral pedal edema, facial puffiness, and reddish urine for one week. Examination revealed pruritic papular lesions over the interdigital spaces, and microscopy confirmed Sarcoptes scabiei infestation. Investigations showed nephrotic-range proteinuria (4.9 g/day), microscopic hematuria, and normal complement levels. Kidney biopsy demonstrated immune complex-mediated MPGN with crescent formation. The patient was treated with topical 5% permethrin and oral ivermectin for scabies, followed by corticosteroid pulses and monthly cyclophosphamide. Complete clinical and biochemical remission occurred within six months. This case highlights scabies as a potential trigger for immune complex-mediated glomerulonephritis through chronic antigenic stimulation. Scabies-associated MPGN, though rare, should be recognized as a treatable cause of immune-mediated kidney injury. Early diagnosis and combined anti-parasitic and immunosuppressive therapy can achieve complete remission.