Korean J Med.  2004 Jul;67(1):73-77.

Rapidly progressive glomerulonephritis associated with infective endocarditis: a dramatically improved case after plasmapheresis

• Han KH
• Choi SW
• Seong IW
• Shin YT
• Suh KS
• Kwon GC
• Jeong JO

Abstract

A 28-year-old woman was admitted due to fever, dyspnea, hematuria and acute renal insufficiency. 1 months ago, she had been diagnosed as having ventricular septal defect with mild dyspnea and chronic cough. Infective endocarditis (IE) was diagnosed by clinical findings including vegetation in echocardiography. A blood culture drawn during the hospitalization grew streptococcus sanguis. A renal biopsy showed IE-induced crescentic glomerulonephritis (GN). Antibiotic treatment alone was effective for fever, but not for gross hematuria and renal insufficiency. After the initiation of plasmapheresis, gross hematuria and acute renal insufficiency was dramatically improved. After clinical stability was achieved, closure of the ventricular septal defect was performed. This result suggests that plasmapheresis may be beneficial in the treatment infective endocarditis-induced crescent GN.

Keyword

Endocarditis; Glomerulonephritis; Plasmapheresis

MeSH Terms

Acute Kidney Injury
Adult
Biopsy
Cough
Dyspnea
Echocardiography
Endocarditis*
Female
Fever
Glomerulonephritis*
Heart Septal Defects, Ventricular
Hematuria
Hospitalization
Humans
Plasmapheresis*
Renal Insufficiency
Streptococcus sanguis