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BACKGROUND Glomerulonephritis (GN) associated with post staphylococcus infection (PSIGN) and high serum immunoglobulin A (IgA) has been reported recently. Patients with GN after infection with underlying IgA nephropathy create a challenge to determine the etiology of GN. Therefore, treatment should be accordingly, with steroids used if the IgA nephropathy flare-up is determined to be the etiology. The aim of this case report was to shed light on the difference between PSIGN and IgA nephropathy flare-ups in patients with a history of IgA nephropathy, and how to treat patient cases accordingly. CASE REPORT An 81-year-old male presented to our Emergency Department complaining of increasing pain, swelling, and redness of his left knee since 2 days ago. He had a history of recent methicillin sensitive Staphylococcus aureus (MSSA) left knee arthroplasty infection that was treated with cefazolin, and he had a history of IgA nephropathy diagnosed 1 year ago. CONCLUSIONS In our patient case, renal biopsy studies were not enough to differentiate between PSIGN and IgA nephropathy flare-ups, thus, clinical presentation was important. PSIGN was found to have a delayed onset compared to IgA nephropathy. Lower serum complement 3 (C3) level, heavier proteinuria, and acute renal failure are common with PSIGN compared to IgA nephropathy. Identifying the etiology and treating our patient accordingly with immunosuppressive therapy had a positive impact on the patient, restoring renal function without further damage.
This article was published in the following journal.
Name: The American journal of case reports
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Glomerulonephritis associated with autoimmune disease SYSTEMIC LUPUS ERYTHEMATOSUS. Lupus nephritis is histologically classified into 6 classes: class I - normal glomeruli, class II - pure mesangial alterations, class III - focal segmental glomerulonephritis, class IV - diffuse glomerulonephritis, class V - diffuse membranous glomerulonephritis, and class VI - advanced sclerosing glomerulonephritis (The World Health Organization classification 1982).
A species of STAPHYLOCOCCUS found on the skin of humans (and non-human primates), often causing hospital-acquired infections (CROSS INFECTION).
A species of STAPHYLOCOCCUS similar to STAPHYLOCOCCUS HAEMOLYTICUS, but containing different esterases. The subspecies Staphylococcus hominis novobiosepticus is highly virulent and novobiocin resistant.
A COAGULASE-negative species of STAPHYLOCOCCUS found on the skin and MUCOUS MEMBRANE of warm-blooded animals. Similar to STAPHYLOCOCCUS EPIDERMIDIS and STAPHYLOCOCCUS HAEMOLYTICUS, it is a nosocomial pathogen in NICU settings. Subspecies include generally antibiotic susceptible and BIOFILM negative capitis and antibiotic resistant and biofilm positive urealyticus isolates.
Summaries that serve as the primary documents communicating a patient's care plan to the post-hospital care team.
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An antibody is a protein produced by the body's immune system when it detects harmful substances, called antigens. Examples of antigens include microorganisms (such as bacteria, fungi, parasites, and viruses) and chemicals. Antibodies may be produc...