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Kidney Week

Abstract: PO1830

A Case of AKI with Nephrotic Syndrome After Intraperitoneal Infection with Methicillin-Sensitive Staphylococcus aureus (MSSA)

Session Information

Category: Trainee Case Report

  • 1202 Glomerular Diseases: Immunology and Inflammation

Authors

  • Okunaga, Issei, Chiba Daigaku Daigakuin Igaku Kenkyuin Igakubu, Chiba, Chiba, Japan
  • Makino, Shinichi, Chiba Daigaku Daigakuin Igaku Kenkyuin Igakubu, Chiba, Chiba, Japan
  • Aizawa, Masashi, Chiba Daigaku Daigakuin Igaku Kenkyuin Igakubu, Chiba, Chiba, Japan
  • Asanuma, Katsuhiko, Chiba Daigaku Daigakuin Igaku Kenkyuin Igakubu, Chiba, Chiba, Japan
Introduction

Postinfectious glomerulonephritis (PIGN) causes acute nephritic syndrome complicated with urinary protein and hematuria after infection but rarely leads to nephrotic syndrome. The effectiveness of steroid for PIGN has been reported, but still controversial. We report a case of refractory nephrotic syndrome caused by PIGN treated with steroid.

Case Description

A 78-year-old man presenting with nausea and dizziness was admitted. He had pancreatectomy for intraductal papillary mucinous tumor two months before. He was diagnosed as postoperative pancreatic fistula with intraperitoneal infection caused by MSSA. During treatment for the infection, he presented acute kidney injury with nephrotic range proteinuria and hematuria, and required hemodialysis. Renal biopsy revealed diffuse endocapillary proliferative glomerulonephritis with cellular crescents. He was diagnosed as nephrotic syndrome caused by PIGN after intraperitoneal infection with MSSA. Since renal failure was persistent despite infection resolution, he started steroid treatment, lead to improve kidney injury.

Discussion

Antibacterial treatment is important for treatment of PIGN, but if the improvement is still poor, steroid treatment may be effective.

Treatment course
POD: Postoperative day, UP: Urine protein, BW: Body waight, A/S: Ampicillin sulbactam, HD: Hemodialysis, PSL:Prednisolone

PAS stain: Diffuse endocapillary proliferative glomerulonephritis with cellular crescents