27 October 2019
: Case report
Collapsing Focal Segmental Glomerulosclerosis with Acute Interstitial Nephritis Associated with Plasmodium Falciparum: A Case Report and Review of the Literature
Rare coexistence of disease or pathology
Muhammad Azhar1BCDEF*, Lutfi Alasadi1BCDEF, Stephen Kemnele1BCDEF, Ira W. Reiser1BCDEF, Samuel Spitalewitz1BCDEFDOI: 10.12659/AJCR.917722
Am J Case Rep 2019; 20:1576-1580
Abstract
BACKGROUND: Malaria adversely affects the kidney in a variety of ways. The most common kidney injury is acute tubular necrosis, although various glomerular lesions are also described. Of these, collapsing focal segmental glomerulosclerosis (cFSGS) is the most rarely seen. Thus, the natural history of this lesion and response to treatment are not clear. Herein, we present a case of cFSGS complicated by acute interstitial nephritis caused by Plasmodium falciparum (P. falciparum) unresponsive to prednisone.
CASE REPORT: A 64-year-old Nigerian man with chronic kidney disease due to hypertensive nephropathy was admitted to the hospital, diagnosed with active P. falciparum malaria infection after returning from Nigeria. He developed acute kidney injury and nephrotic range proteinuria. Renal biopsy showed acute interstitial nephritis and cFSGS. Despite corticosteroid therapy, his kidney function worsened, requiring initiation of renal replacement therapy. This is the fifth case report of cFSGS due to malaria P. falciparum but the first to report the presence of acute interstitial nephritis in association with cFSGS due to malaria.
CONCLUSIONS: cFSGS is rarely seen as a manifestation of P. falciparum infection. When associated with acute interstitial nephritis, the prognosis seems to be worse. It appears that age and co-morbidities are the risk factors for unresponsiveness to corticosteroids, and treatment of the renal disease should focus on rapidly eradicating the parasitemia and providing supportive care. Our case report is the first to describe a combination of cFSGS and interstitial nephritis caused by P. falciparum unresponsive to corticosteroids.
Keywords: Glomerulosclerosis, Focal Segmental, Kidney Failure, Chronic, Malaria, Plasmodium falciparum, Prednisone, Drug Resistance, Malaria, Falciparum, Middle Aged, Nephritis, Interstitial, Nigeria, Renal Replacement Therapy
SARS-CoV-2/COVID-19
22 February 2023 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.938732
22 February 2023 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.938761
16 March 2023 : Case report
Am J Case Rep 2023; 24:e938359
01 March 2023 : Case report
Am J Case Rep 2023; 24:e937955
In Press
17 Mar 2023 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.939411
17 Mar 2023 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.939474
16 Mar 2023 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.938752
15 Mar 2023 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.938875
Most Viewed Current Articles
13 Jul 2022 : Case report
DOI :10.12659/AJCR.936441
Am J Case Rep 2022; 23:e936441
06 Dec 2021 : Case report
DOI :10.12659/AJCR.934406
Am J Case Rep 2021; 22:e934406
23 Feb 2022 : Case report
DOI :10.12659/AJCR.935250
Am J Case Rep 2022; 23:e935250
07 Dec 2021 : Case report
DOI :10.12659/AJCR.934347
Am J Case Rep 2021; 22:e934347