Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Glomerulonephritis Associated with Nonstreptococcal Infection Clinical Presentation

  • Author: James W Lohr, MD; Chief Editor: Vecihi Batuman, MD, FACP, FASN  more...
 
Updated: Apr 28, 2015
 

History

Presentation may vary from asymptomatic hematuria to a full-blown acute nephritic syndrome consisting of proteinuria, edema, hypertension, and renal failure.

  • Hematuria may be gross or microscopic.
  • Patients may have evidence of edema.
  • Patients may report fever, night sweats, and rigors.
  • Weight loss is a possible complaint.
  • Patients may report arthralgias.
  • Abdominal, chest, or back pain may be caused by a visceral abscess.
  • Patients may have history of shunt placement for hydrocephalus, or they may have a vascular graft that has become infected.
  • Patients with hepatitis B or C may have a history of intravenous drug abuse, needle stick injury, blood transfusions, or sexual promiscuity.
  • Patients with HIV infection may have history of intravenous drug abuse, hemophilia, history of blood transfusion from 1977-1985, unprotected sex with multiple partners, or tuberculosis.
Next

Physical

Hypertension may be due to renal failure.

Edema due to nephrotic syndrome is unusual but can develop in as many as 30% of cases associated with shunt nephritis.

Rash may be maculopapular or purpuric.

Lymphadenopathy is a reported finding.

Patients may have hepatosplenomegaly.

Findings of subacute bacterial endocarditis (SBE) may include the following:

  • Heart murmur
  • Purpura
  • Roth spots
  • Janeway lesions
Previous
Next

Causes

Infections with bacteria, viruses, protozoa, and helminths can cause postinfectious GN (PIGN).

  • Bacterial endocarditis: PIGN occurs more commonly in subacute rather than acute endocarditis. S aureus is now the most common pathogen recognized.[8]
  • Shunt nephritis: This may be associated with ventriculovascular, ventriculoperitoneal, peritoneovascular, or vascular shunts.[9]
  • Visceral abscesses: These may occur with abdominal, pulmonary, or retroperitoneal abscesses.
  • Syphilis
  • Hepatitis B[5]
  • Hepatitis C[5, 4]
  • Human immunodeficiency virus[5, 10, 6]
  • Cytomegalovirus
  • Parvovirus B19
  • Hantavirus
  • Malaria
  • Schistosomiasis[11]
  • Leishmaniasis
  • Filariasis
  • Hydatid disease
  • Toxoplasmosis
  • Aspergillosis
Previous
 
 
Contributor Information and Disclosures
Author

James W Lohr, MD Professor, Department of Internal Medicine, Division of Nephrology, Fellowship Program Director, University of Buffalo State University of New York School of Medicine and Biomedical Sciences

James W Lohr, MD is a member of the following medical societies: American College of Physicians, American Heart Association, American Society of Nephrology, Central Society for Clinical and Translational Research

Disclosure: Partner received salary from Alexion for employment.

Coauthor(s)

Quresh T Khairullah, MBBS, MD 

Quresh T Khairullah, MBBS, MD is a member of the following medical societies: American College of Physicians, American Society of Nephrology, International Society of Nephrology

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Ajay K Singh, MB, MRCP, MBA Associate Professor of Medicine, Harvard Medical School; Director of Dialysis, Renal Division, Brigham and Women's Hospital; Director, Brigham/Falkner Dialysis Unit, Faulkner Hospital

Disclosure: Nothing to disclose.

Chief Editor

Vecihi Batuman, MD, FACP, FASN Huberwald Professor of Medicine, Section of Nephrology-Hypertension, Tulane University School of Medicine; Chief, Renal Section, Southeast Louisiana Veterans Health Care System

Vecihi Batuman, MD, FACP, FASN is a member of the following medical societies: American College of Physicians, American Society of Hypertension, American Society of Nephrology, International Society of Nephrology

Disclosure: Nothing to disclose.

References
  1. Sorger K. Postinfectious glomerulonephritis. Subtypes, clinico-pathological correlations, and follow-up studies. Veroff Pathol. 1986. 125:1-105. [Medline].

  2. Chadban SJ, Atkins RC. Glomerulonephritis. Lancet. 2005 May 21-27. 365(9473):1797-806. [Medline].

  3. Conlon PJ, Jefferies F, Krigman HR, et al. Predictors of prognosis and risk of acute renal failure in bacterial endocarditis. Clin Nephrol. 1998 Feb. 49(2):96-101. [Medline].

  4. Kamar N, Izopet J, Alric L, et al. Hepatitis C virus-related kidney disease: an overview. Clin Nephrol. 2008 Mar. 69(3):149-60. [Medline].

  5. Appel G. Viral infections and the kidney: HIV, hepatitis B, and hepatitis C. Cleve Clin J Med. 2007 May. 74(5):353-60. [Medline].

  6. Wyatt CM, Rosenstiel PE, Klotman PE. HIV-associated nephropathy. Contrib Nephrol. 2008. 159:151-61. [Medline].

  7. Nasr SH, Fidler ME, Valeri AM, et al. Postinfectious glomerulonephritis in the elderly. J Am Soc Nephrol. 2011 Jan. 22(1):187-95. [Medline].

  8. Kambham N. Postinfectious glomerulonephritis. Adv Anat Pathol. 2012 Sep. 19(5):338-47. [Medline].

  9. Haffner D, Schindera F, Aschoff A, et al. The clinical spectrum of shunt nephritis. Nephrol Dial Transplant. 1997 Jun. 12(6):1143-8. [Medline].

  10. Lu TC, Ross M. HIV-associated nephropathy: a brief review. Mt Sinai J Med. 2005 May. 72(3):193-9. [Medline].

  11. Barsoum R. The changing face of schistosomal glomerulopathy. Kidney Int. 2004 Dec. 66(6):2472-84. [Medline].

  12. Takeshima E, Morishita Y, Ogura M, Ito C, Saito O, Takemoto F, et al. A case of diffuse endocapillary proliferative glomerulonephritis associated with polymyalgia rheumatica. Case Rep Nephrol Urol. 2012 Jul. 2(2):158-64. [Medline]. [Full Text].

  13. Tang S, Lai FM, Lui YH, et al. Lamivudine in hepatitis B-associated membranous nephropathy. Kidney Int. 2005 Oct. 68(4):1750-8. [Medline].

  14. Jefferson JA, Johnson RJ. Treatment of hepatitis C-associated glomerular disease. Semin Nephrol. 2000 May. 20(3):286-92. [Medline].

  15. Atta MG, Gallant JE, Rahman MH, et al. Antiretroviral therapy in the treatment of HIV-associated nephropathy. Nephrol Dial Transplant. 2006 Oct. 21(10):2809-13. [Medline].

Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.