Infection-Related Cryoglobulinemic Glomerulonephritis with Serum Anti-Factor B Antibodies Identified and Staining for NAPlr/Plasmin Activity Due to Infective Endocarditis

• Published in: International journal of molecular sciences Vol. 24; no. 11; p. 9369
• Main Authors: Toishi, Takumi, Oda, Takashi, Hamano, Atsuro, Sugihara, Shinnosuke, Inoue, Tomohiko, Kawaji, Atsuro, Nagaoka, Kanako, Matsunami, Masatoshi, Fukuda, Junko, Ohara, Mamiko, Suzuki, Tomo
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 27-05-2023; MDPI
• Subjects: Antibodies; Bacterial infections; Biopsy; Blood; Blood culture; Case Report; Case reports; Cell culture; Cell proliferation; Complement component C3; Complement component C4; cryoglobulinemic glomerulonephritis; Echocardiography; Electron microscopy; Endocarditis; factor B; Glomerulonephritis; Hepatitis; Immunoglobulin M; Immunoglobulins; Infection; infection-related glomerulonephritis; Infections; Infective endocarditis; Leukocytes; Leukocytes (neutrophilic); Light microscopy; Medical examination; Microscopy; Nephritis; nephritis-associated plasmin receptor (NAPlr); Neutrophils; Optical microscopy; Plasmin; Proteinase; Proteinase 3; Staining; Japan; nephritis-associated plasmin receptor (NAPlr); infective endocarditis; factor B; infection-related glomerulonephritis; cryoglobulinemic glomerulonephritis
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms24119369

In this rare case of infection-related cryoglobulinemic glomerulonephritis with infective endocarditis, a 78-year-old male presented with an acute onset of fever and rapidly progressive glomerulonephritis. His blood culture results were positive for
, and transesophageal echocardiography showed vegetation. He was diagnosed with endocarditis. His serum immunoglobulin M, IgM-cryoglobulin, and proteinase-3-anti-neutrophil cytoplasmic antibody levels were elevated, and his serum complement 3 (C3) and C4 levels were decreased. Renal biopsy results showed endocapillary proliferation, mesangial cell proliferation, and no necrotizing lesions on light microscopy, with strong positive staining for IgM, C3, and C1q in the capillary wall. Electron microscopy showed deposits in the mesangial area in the form of fibrous structures without any humps. Histological examination confirmed a diagnosis of cryoglobulinemic glomerulonephritis. Further examination showed the presence of serum anti-factor B antibodies and positive staining for nephritis-associated plasmin receptor and plasmin activity in the glomeruli, suggesting infective endocarditis-induced cryoglobulinemic glomerulonephritis.