Korean J Intern Med.  2013 Nov;28(6):728-731. 10.3904/kjim.2013.28.6.728.

A case of Tsutsugamushi disease presenting with nephrotic syndrome

• Lee JH
• Lee MJ
• Shin DH
• Kang SW
• Choi KH
• Yoo TH

• KMID: 1780136
• DOI: http://doi.org/10.3904/kjim.2013.28.6.728

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.

Keyword

Nephrotic syndrome; Scrub typhus; Glomerulonephritis; Membranous

MeSH Terms

Aged
Anti-Bacterial Agents/therapeutic use
Antibodies, Bacterial/blood
Biopsy
Doxycycline/therapeutic use
Female
Glomerulonephritis, Membranous/diagnosis/*etiology
Humans
Nephrotic Syndrome/diagnosis/*etiology
Orientia tsutsugamushi/immunology
Scrub Typhus/*complications/diagnosis/drug therapy/microbiology
Treatment Outcome
Anti-Bacterial Agents
Antibodies, Bacterial
Doxycycline