The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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A case of Tsutsugamushi disease presenting with nephrotic syndrome

  • Lee, Ju Hyun (Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Lee, Mi Jung (Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Shin, Dong Ho (Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kang, Shin-Wook (Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Choi, Kyu Hun (Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Yoo, Tae-Hyun (Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine)
  • Received : 2012.04.16
  • Accepted : 2012.06.29
  • Published : 2013.11.01
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Abstract

Nephrotic syndrome associated with Tsutsugamushi disease has not been previously reported. We are describing a case of Tsutsugamuchi disease presenting with nephrotic syndrome. A 72-year-old woman presented with fever and generalized edema. Laboratory studies revealed a leukocytosis, hypoalbuminemia, and hypercholesterolemia. Her urine protein excretion was 5.4 g/day. The anti-Tsutsugamushi antibody test was strongly positive (1:2,560). A renal biopsy was performed, and pathologic findings revealed membranous glomerulonephritis. The patient′s clinical symptoms improved markedly after treatment with doxycycline.

Keywords

References

  1. Chang WH. Current status of tsutsugamushi disease in Korea. J Korean Med Sci 1995;10:227-238.
  2. Hong JH, Oho JH, Kim JH, Kho DK. A case of acute renal failure associated with Tsutsugamushi disease. J Korean Pediatr Soc 2001;44:464-468.
  3. Hsu GJ, Young T, Peng MY, Chang FY, Chou MY, Sheu LF. Acute renal failure associated with scrub typhus: report of a case. J Formos Med Assoc 1993;92:475-477.
  4. Yen TH, Chang CT, Lin JL, Jiang JR, Lee KF. Scrub typhus: a frequently overlooked cause of acute renal failure. Ren Fail 2003;25:397-410. https://doi.org/10.1081/JDI-120021152
  5. Young PC, Hae CC, Lee KH, Hoon CJ. Tsutsugamushi infection-associated acute rhabdomyolysis and acute renal failure. Korean J Intern Med 2003;18:248-250.
  6. Chi WC, Huang JJ, Sung JM, Lan RR, Ko WC, Chen FF. Scrub typhus associated with multiorgan failure: a case report. Scand J Infect Dis 1997;29:634-635. https://doi.org/10.3109/00365549709035911
  7. Barbiano Di Belgiojoso G, Genderini A, Ferrario F. Post-infectious glomerulonephritis. G Ital Nefrol 2003;20:184-199.
  8. Lai AS, Lai KN. Viral nephropathy. Nat Clin Pract Nephrol 2006;2:254-262.
  9. Sobh MA, Moustafa FE, Sally SM, Deelder AM, Ghoniem MA. Effect of anti-schistosomal treatment on schistosomal-specif ic nephropathy. Nephrol Dial Transplant 1988;3:744-751.
  10. Chen HW, Zhang Z, Huber E, et al. Identification of cross-reactive epitopes on the conserved 47-kilodalton antigen of Orientia tsutsugamushi and human serine protease. Infect Immun 2009;77:2311-2319. https://doi.org/10.1128/IAI.01298-08

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