Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. May 25, 2023; 12(3): 66-72
Published online May 25, 2023. doi: 10.5527/wjn.v12.i3.66
Infection related membranoproliferative glomerulonephritis secondary to anaplasmosis: A case report
Maulik K Lathiya, Praveen Errabelli, Salvatore Mignano, Susan M Cullinan
Maulik K Lathiya, Susan M Cullinan, Department of Emergency Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, United States
Praveen Errabelli, Department of Nephrology, Mayo Clinic Health System, Eau Claire, WI 54703, United States
Salvatore Mignano, Department of Pathology, Mayo Clinic, Rochester, MN 55905, United States
Author contributions: Lathiya MK and Errabelli P contributed to the conceptualization, writing, original draft preparation, graphics, reviewing; Mignano S contributed to original draft preparation, reviewing and editing; Cullinan SM contributed to reviewing and editing.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
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Corresponding author: Maulik K Lathiya, Department of Emergency Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, United States. lathiya.maulik@mayo.edu
Received: March 8, 2023
Peer-review started: March 8, 2023
First decision: April 28, 2023
Revised: May 5, 2023
Accepted: May 17, 2023
Article in press: May 17, 2023
Published online: May 25, 2023
Processing time: 71 Days and 12.7 Hours
Abstract
BACKGROUND

Anaplasmosis is a tick-borne disease with a range of clinical manifestations, from a flu-like illness with fever and myalgias to a severe systemic disease with multisystem organ failure. Although renal involvement is not a common presentation, there have been few cases reporting acute kidney injury from Anaplasmosis.

CASE SUMMARY

We present a 55-year-old female with anaplasmosis who developed acute kidney injury due to membranoproliferative glomerulonephritis (MPGN). The patient originally presented with cough and shortness of breath. She was admitted to the hospital with a diagnosis of community acquired pneumonia and received antibiotics. During the hospital course she developed severe acute renal failure. Initial serological work up didn’t provide any conclusive diagnosis. Hence, she underwent kidney biopsy which showed MPGN pattern suggesting autoimmune, multiple myeloma or infectious etiology. Extensive work up was undertaken which was negative for autoimmune diseases, vasculitis panel, paraproteinemias but tested positive for IgG anaplasma with high titers indicating Anaplasmosis.

CONCLUSION

Our case shows a unique presentation of severe acute renal failure from MPGN from tick borne illness. MPGN is usually seen with autoimmune diseases, hepatitis C virus infections, paraproteinemias. Hence, we suggest that tick borne illness should also be considered when evaluating acute renal failure cases in tick borne prevalent regions.

Keywords: Acute kidney injury; Membranoproliferative glomerulonephritis; Tick-borne; Anaplasmosis; Case report

Core Tip: In areas endemic for tick borne illnesses, it is important to learn and understand common and rare presentations of tick borne illness. Our case is unique as it showed that tick borne illness can also cause severe renal failure by inciting Glomerulonephritis which is usually seen with other etiologies but very rarely with Anaplasmosis.