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Membranoproliferative glomerulonephritis in patients with chronic venous catheters: a case report and literature review.

Sy J, Nast CC, Pham PT, Pham PC - Case Rep Nephrol (2014)

Bottom Line: Chronic indwelling catheters have been reported to be associated with membranoproliferative glomerulonephritis (MPGN) via the activation of the classical complement pathway in association with bacterial infections such as coagulase negative staphylococcus.We herein provide supporting evidence for the direct causal relationship between chronic catheter infections and MPGN via a case of recurrent MPGN associated with recurrent catheter infections used for total parenteral nutrition (TPN) in a man with short gut syndrome.We also present a literature review of similar cases and identify common clinical manifestations that may serve to aid clinicians in the early identification of MPGN associated with infected central venous catheterization or vice versa.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology and Hypertension, Department of Internal Medicine, UCLA-Olive View Medical Center, 14445 Olive View Drive, 2B-182, Sylmar, CA 91342, USA.

ABSTRACT
Chronic indwelling catheters have been reported to be associated with membranoproliferative glomerulonephritis (MPGN) via the activation of the classical complement pathway in association with bacterial infections such as coagulase negative staphylococcus. We herein provide supporting evidence for the direct causal relationship between chronic catheter infections and MPGN via a case of recurrent MPGN associated with recurrent catheter infections used for total parenteral nutrition (TPN) in a man with short gut syndrome. We also present a literature review of similar cases and identify common clinical manifestations that may serve to aid clinicians in the early identification of MPGN associated with infected central venous catheterization or vice versa. The importance of routine monitoring of kidney function and urinalysis among patients with chronic central venous catheterization is highlighted as kidney injury may herald or coincide with overtly infected chronic indwelling central venous catheters.

No MeSH data available.


Related in: MedlinePlus

Glomerular renal biopsy findings. (a) Mesangial and endocapillary hypercellularity with a lobular pattern and segmental capillary double contours (periodic acid methenamine silver ×400). (b) Peripheral granular staining for C3 (×400). (c) Capillary wall subendothelial electron dense deposits with peripheral mesangial migration and new subendothelial basement membrane material forming a double contour (×19,000).
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fig1: Glomerular renal biopsy findings. (a) Mesangial and endocapillary hypercellularity with a lobular pattern and segmental capillary double contours (periodic acid methenamine silver ×400). (b) Peripheral granular staining for C3 (×400). (c) Capillary wall subendothelial electron dense deposits with peripheral mesangial migration and new subendothelial basement membrane material forming a double contour (×19,000).

Mentions: Light microscopy revealed 15 glomeruli showing a lobular pattern with mesangial hypercellularity, a moderate number of capillary wall double contours, and leukocytes within capillary lumina. Three glomeruli had segmental crescents. There were interstitial inflammation and edema, associated with acute tubular cell injury. Immunofluorescence microscopy disclosed five glomeruli staining for IgM (3+), C3 (3+), and kappa (trace to 1+) and lambda (trace) light chains along capillary walls in a granular pattern and peripheral distribution. Mesangial regions were stained for IgM (1 to 2+), C1q (trace), C3 (1+), and kappa (trace) and lambda (trace) light chains in a granular pattern. Electron microscopy of three glomeruli revealed small subendothelial and few mesangial electron dense deposits. There were no tubuloreticular structures in the cytoplasm of any cells (Figure 1).


Membranoproliferative glomerulonephritis in patients with chronic venous catheters: a case report and literature review.

Sy J, Nast CC, Pham PT, Pham PC - Case Rep Nephrol (2014)

Glomerular renal biopsy findings. (a) Mesangial and endocapillary hypercellularity with a lobular pattern and segmental capillary double contours (periodic acid methenamine silver ×400). (b) Peripheral granular staining for C3 (×400). (c) Capillary wall subendothelial electron dense deposits with peripheral mesangial migration and new subendothelial basement membrane material forming a double contour (×19,000).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3926371&req=5

fig1: Glomerular renal biopsy findings. (a) Mesangial and endocapillary hypercellularity with a lobular pattern and segmental capillary double contours (periodic acid methenamine silver ×400). (b) Peripheral granular staining for C3 (×400). (c) Capillary wall subendothelial electron dense deposits with peripheral mesangial migration and new subendothelial basement membrane material forming a double contour (×19,000).
Mentions: Light microscopy revealed 15 glomeruli showing a lobular pattern with mesangial hypercellularity, a moderate number of capillary wall double contours, and leukocytes within capillary lumina. Three glomeruli had segmental crescents. There were interstitial inflammation and edema, associated with acute tubular cell injury. Immunofluorescence microscopy disclosed five glomeruli staining for IgM (3+), C3 (3+), and kappa (trace to 1+) and lambda (trace) light chains along capillary walls in a granular pattern and peripheral distribution. Mesangial regions were stained for IgM (1 to 2+), C1q (trace), C3 (1+), and kappa (trace) and lambda (trace) light chains in a granular pattern. Electron microscopy of three glomeruli revealed small subendothelial and few mesangial electron dense deposits. There were no tubuloreticular structures in the cytoplasm of any cells (Figure 1).

Bottom Line: Chronic indwelling catheters have been reported to be associated with membranoproliferative glomerulonephritis (MPGN) via the activation of the classical complement pathway in association with bacterial infections such as coagulase negative staphylococcus.We herein provide supporting evidence for the direct causal relationship between chronic catheter infections and MPGN via a case of recurrent MPGN associated with recurrent catheter infections used for total parenteral nutrition (TPN) in a man with short gut syndrome.We also present a literature review of similar cases and identify common clinical manifestations that may serve to aid clinicians in the early identification of MPGN associated with infected central venous catheterization or vice versa.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology and Hypertension, Department of Internal Medicine, UCLA-Olive View Medical Center, 14445 Olive View Drive, 2B-182, Sylmar, CA 91342, USA.

ABSTRACT
Chronic indwelling catheters have been reported to be associated with membranoproliferative glomerulonephritis (MPGN) via the activation of the classical complement pathway in association with bacterial infections such as coagulase negative staphylococcus. We herein provide supporting evidence for the direct causal relationship between chronic catheter infections and MPGN via a case of recurrent MPGN associated with recurrent catheter infections used for total parenteral nutrition (TPN) in a man with short gut syndrome. We also present a literature review of similar cases and identify common clinical manifestations that may serve to aid clinicians in the early identification of MPGN associated with infected central venous catheterization or vice versa. The importance of routine monitoring of kidney function and urinalysis among patients with chronic central venous catheterization is highlighted as kidney injury may herald or coincide with overtly infected chronic indwelling central venous catheters.

No MeSH data available.


Related in: MedlinePlus