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Acute poststreptococcal glomerulonephritis with acute interstitial nephritis related to streptococcal pyrogenic exotoxin B.

Ando F, Sohara E, Ito E, Okado T, Rai T, Uchida S, Sasaki S - Clin Kidney J (2013)

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Initial laboratory investigations revealed serum creatinine, 170 µmol/L; complement C3, 130 mg/L and antistreptolysin O titer, 538 IU/mL (reference, <239 IU/mL)... Transient type 4 renal tubular acidosis was observed during steroid treatment... AIN is found in the infectious diseases of children, particularly in streptococcal infection... We investigated the localization of two streptococcal antigens, streptococcal pyrogenic exotoxin B (SPEB) and nephritis-associated plasmin receptor (NAPlr), using an anti-SPEB antibody (Abcam, Cambridge, MA) and a fluorescein isothiocyanate-conjugated anti-NAPlr antibody [1F10] (Abcam)... Although NAPlr was not detected, SPEB was positive in the interstitium as well as glomeruli (Figure 1C–F)... Chang et al. reported a case of streptococcal infection-related AIN, in which SPEB was found in both tubular epithelial cells and interstitium... In the present case, negative results were obtained for SPEB in tubular epithelial cells... Similarly, SPEB and its precursors have been detected only in glomeruli and interstitium in the rat kidney... SPEB has been reported in association with the pathogenesis of APSGN... The mechanisms of leukocyte infiltration could be mediated by chemotactic effects and the migration inhibitor factor-like activities of SPEB... SPEB also induces proliferation of human mononuclear leukocytes... SPEB may be one of the causes of streptococcal infection-related AIN.

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(A and B) Findings of the kidney biopsy. Hematoxylin and eosin-stained section showing diffuse endocapillary proliferation with massive infiltration of neutrophils (A) and inflammatory cells infiltration in the cortical interstitium (B). (C–F) SPEB localization relative to the tubulointerstitium. Confocal microscopy images of double immunofluorescence staining for SPEB (C, FITC) and CD10 (D, Alexa Fluor 594) with a merged image (E). IgA nephritis case as a negative control (F).
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SFT045F1: (A and B) Findings of the kidney biopsy. Hematoxylin and eosin-stained section showing diffuse endocapillary proliferation with massive infiltration of neutrophils (A) and inflammatory cells infiltration in the cortical interstitium (B). (C–F) SPEB localization relative to the tubulointerstitium. Confocal microscopy images of double immunofluorescence staining for SPEB (C, FITC) and CD10 (D, Alexa Fluor 594) with a merged image (E). IgA nephritis case as a negative control (F).

Mentions: A percutaneous kidney biopsy was performed. Light microscopy contained 20 glomeruli, 4 of which were globally sclerotic and 1 of which showed cellular crescent formation. Diffuse endocapillary proliferative glomerulonephritis was identified (Figure 1A). Forty percent of the interstitium was infiltrated by inflammatory cells (Figure 1B). Immunofluorescent staining revealed complement C3, mainly on capillary walls.Fig. 1.


Acute poststreptococcal glomerulonephritis with acute interstitial nephritis related to streptococcal pyrogenic exotoxin B.

Ando F, Sohara E, Ito E, Okado T, Rai T, Uchida S, Sasaki S - Clin Kidney J (2013)

(A and B) Findings of the kidney biopsy. Hematoxylin and eosin-stained section showing diffuse endocapillary proliferation with massive infiltration of neutrophils (A) and inflammatory cells infiltration in the cortical interstitium (B). (C–F) SPEB localization relative to the tubulointerstitium. Confocal microscopy images of double immunofluorescence staining for SPEB (C, FITC) and CD10 (D, Alexa Fluor 594) with a merged image (E). IgA nephritis case as a negative control (F).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400488&req=5

SFT045F1: (A and B) Findings of the kidney biopsy. Hematoxylin and eosin-stained section showing diffuse endocapillary proliferation with massive infiltration of neutrophils (A) and inflammatory cells infiltration in the cortical interstitium (B). (C–F) SPEB localization relative to the tubulointerstitium. Confocal microscopy images of double immunofluorescence staining for SPEB (C, FITC) and CD10 (D, Alexa Fluor 594) with a merged image (E). IgA nephritis case as a negative control (F).
Mentions: A percutaneous kidney biopsy was performed. Light microscopy contained 20 glomeruli, 4 of which were globally sclerotic and 1 of which showed cellular crescent formation. Diffuse endocapillary proliferative glomerulonephritis was identified (Figure 1A). Forty percent of the interstitium was infiltrated by inflammatory cells (Figure 1B). Immunofluorescent staining revealed complement C3, mainly on capillary walls.Fig. 1.

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Initial laboratory investigations revealed serum creatinine, 170 µmol/L; complement C3, 130 mg/L and antistreptolysin O titer, 538 IU/mL (reference, <239 IU/mL)... Transient type 4 renal tubular acidosis was observed during steroid treatment... AIN is found in the infectious diseases of children, particularly in streptococcal infection... We investigated the localization of two streptococcal antigens, streptococcal pyrogenic exotoxin B (SPEB) and nephritis-associated plasmin receptor (NAPlr), using an anti-SPEB antibody (Abcam, Cambridge, MA) and a fluorescein isothiocyanate-conjugated anti-NAPlr antibody [1F10] (Abcam)... Although NAPlr was not detected, SPEB was positive in the interstitium as well as glomeruli (Figure 1C–F)... Chang et al. reported a case of streptococcal infection-related AIN, in which SPEB was found in both tubular epithelial cells and interstitium... In the present case, negative results were obtained for SPEB in tubular epithelial cells... Similarly, SPEB and its precursors have been detected only in glomeruli and interstitium in the rat kidney... SPEB has been reported in association with the pathogenesis of APSGN... The mechanisms of leukocyte infiltration could be mediated by chemotactic effects and the migration inhibitor factor-like activities of SPEB... SPEB also induces proliferation of human mononuclear leukocytes... SPEB may be one of the causes of streptococcal infection-related AIN.

No MeSH data available.


Related in: MedlinePlus