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Published on: May 7, 2012
Endocapillary proliferative glomerulonephritis in a patient with parvovirus B19 infection
A Komatsuda1, H Ohtani, T Nimura
1Third Department of Internal Medicine, Akita University School of Medicine, and the Department of Internal Medicine, Senboku General Hospital, Akita, Japan.komatsud@med.akita-u.ac.jp
Insights
Human parvovirus B19 (HPV) infection can cause immune complex glomerulonephritis. This condition involves HPV antigen-antibody complexes depositing in the kidneys, leading to nephritic syndrome.
Area of Science:
- Nephrology
- Virology
- Immunology
Background:
- Erythema infectiosum, a common childhood illness caused by human parvovirus B19 (HPV), can rarely present with renal complications.
- Acute nephritic syndrome is a clinical manifestation characterized by hematuria, hypertension, and renal dysfunction.
Observation:
- A 45-year-old woman presented with acute nephritic syndrome following erythema infectiosum.
- Laboratory tests revealed decreased complement levels (C3, C4, CH50) and positive IgM and IgG antibodies to HPV.
- Renal biopsy demonstrated diffuse endocapillary proliferative glomerulonephritis with granular deposits of IgG, IgM, and C3.
Findings:
- Immunohistochemistry confirmed the presence of HPV antigen within the glomeruli.
- Electron microscopy identified electron-dense deposits in the subendothelial and paramesangial areas.
- These findings indicate glomerular deposition of HPV antigen-antibody complexes.
Implications:
- This case suggests a causal link between HPV infection and immune complex-type glomerulonephritis.
- Understanding this association may aid in diagnosing and managing renal complications in HPV-infected individuals.
- Further research is warranted to elucidate the precise mechanisms of HPV-induced glomerulonephritis.
Abstract:
A 45-year-old woman developed acute nephritic syndrome after erythema infectiosum. Laboratory data on admission showed decreased serum C3, C4, and CH50 levels and the presence of both immunoglobulin (Ig) M and IgG antibodies to human parvovirus B19 (HPV). A renal biopsy showed diffuse endocapillary proliferative glomerulonephritis. Immunofluorescence microscopy indicated 2+ granular staining for IgG, IgM, and C3 over the mesangial area and along glomerular capillary walls. HPV antigen was also detected in glomeruli by immunohistochemistry. Electron microscopy showed electron-dense deposits in the subendothelial space and the paramesangial area. These findings suggest that immune complex-type glomerulonephritis is caused by glomerular deposition of HPV antigen-antibody complexes in some patients with HPV infection.
