Microfilaria in Kidney Biopsy Presenting with Nephrotic Range Proteinuria
A Case Report
Keywords:
Microfilariae, kidney biopsy, nephrotic syndrome, filarial nephropathy
Abstract
Background: A 59 year old male from the North was referred with Nephrotic Syndrome and heavy proteinuria (8gm) and weakness. Urine examination showed 2-3 pus cells, 4+ protein. Two cores of renal tissue were submitted in buffered formalin and Michel’s transport medium. Objective: The case is presented for its rarity. The discussion will include immunological review and glomerular patterns of injury associated with Microfilaria. Result: The immunofluorescence pattern was negative for IgG, IgM, IgA, C3, C4, C1q, kappa and lambda. The light microscopy revealed 3 glomeruli showing mild increase in mesangial cellularity. Tubules show cloudy change. Interstitium shows focal lymphoid infiltrate. An unusual finding is the presence of segmented microfilaria in glomerular capillaries. Conclusion: Diagnosis of filariasis on kidney biopsy by identifying microfilaria is rare. High index of suspicion is required to diagnose filariasis due to its wide range of clinical presentation and laboratory findings. In the archives of 11O8 renal biopsies over a period of 4 years, this is the first case we came across.References
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2. Dreyer G, Dreyer P, Piessens WF. Extralymphatic disease due to bancroftian filariasis. Braz J Med Biol Res. 1999; 32(12):1467–72.
3. Van Velthuysen M-LF, Florquin S. Glomerulopathy Associated with Parasitic Infections. Clinical Microbiology Reviews. 2000; 13(1):55-66.
4. Ramchandra R, Jha V. Nematode Infections. In. Neil Turner N, Goldsmith D, Winearls C, Lamierre N, Himmelfarb J, Remuzzi G. Oxford Textbook of Clinical Nephrology. 4th Ed. Oxford University Press. 2005; 1P.1602-3.
5. Chaturvedi P, Harinath BC, Reddy MV, et al. Filarial antibody detection in suspected occult filariasis in children in an endemic area. J Trop Pediatr. 1995; 41:243-5.
6. Vankalakunti M, Jha PK, Ravishankar B, Vishwanath S, Rampure S, Sudar-shan BH. Microfilariae-associated nephrotic range proteinuria. Kidney Int. 2011; 79(10):1152.
7. Shubham S, Ahuja A, Bhardwaj M Microfilaria in Kidney biopsy: A report of two cases. J Infect Public Health.2018; 11(5):732-734
Published
2019-05-02
Issue
Section
Case Report
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