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Severe acute kidney injury induced by crescentic glomerulonephritis in a child with infective endocarditis

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dc.contributor.author Yilmaz, Neslihan
dc.contributor.author Yuksel, Selcuk
dc.contributor.author Gurses, Dolunay
dc.contributor.author Girisgen, Ilknur
dc.contributor.author Becerir, Tulay
dc.contributor.author Yilmaz, Munevver
dc.contributor.author Ufuk, Furkan
dc.date.accessioned 2023-01-09T21:09:57Z
dc.date.available 2023-01-09T21:09:57Z
dc.date.issued 2022
dc.identifier.issn 0041-4301
dc.identifier.uri https://doi.org/10.24953/turkjped.2021.4397
dc.identifier.uri https://search.trdizin.gov.tr/yayin/detay/1139238
dc.identifier.uri http://acikerisim.pau.edu.tr:8080/xmlui/handle/11499/46206
dc.description.abstract Background. Kidney involvement related to infective endocarditis (IE) may present with different clinical findings. The most common histopathological finding of renal involvement is a combination of proliferative and exudative glomerulonephritis. However, severe acute kidney injury (AKI) induced by crescentic glomerulonephritis (CGN) is extremely rare in children with IE. To date, only 4 pediatric cases with IE-induced CGN had been reported. We present a 14-year old girl with IE-induced CGN. Case. A 14-year old girl with fever, macroscopic hematuria, oliguria, and acute kidney injury (AKI) was admitted to our clinic. The medical history revealed that the patient had undergone several cardiac interventions due to truncus arteriosus type 1, and she recovered from IE-induced glomerulonephritis following antibiotherapy six months ago. During admission, the patient was diagnosed with IE according to one major (positive imaging finding) and three minor (fever, predisposing cardiac disease, and immunological criterion) criteria. Immediate antibiotic treatment was initiated. A kidney biopsy was performed, which showed crescentic glomerulonephritis (CGN with crescents, >50%). Daily pulse steroid (3 days), monthly pulse cyclophosphamide (6 doses), and oral steroid (2 mg/kg/day) therapy were initiated with gradual dose tapering. The patient underwent 12 hemodialysis sessions until the 38th day of the treatment. She was discharged on the 45th day of treatment with normal kidney function tests and negative acute phase reactants. Treatment was maintained with mycophenolate mofetil (MMF) after a 6-month course of cyclophosphamide. MMF was discontinued in the 12th month. At the 18th -month follow-up visit the patient had mild proteinuria, and was on ramipril therapy. Conclusions. The occurrence of CGN should be considered in children with predisposing cardiac disease, who develop hematuria, proteinuria, and severe AKI. Although antibiotic therapy alone is often sufficient in this immune complex GN induced by infection, early initiation of additional immunosuppressive therapy in the presence of CGN may be beneficial for long term preservation of kidney functions. en_US
dc.language.iso en en_US
dc.publisher Turkish J Pediatrics en_US
dc.relation.ispartof Turkish Journal Of Pediatrics en_US
dc.rights info:eu-repo/semantics/openAccess en_US
dc.subject infective endocarditis en_US
dc.subject crescentic glomerulonephritis en_US
dc.subject children en_US
dc.subject vegetation en_US
dc.subject Immune-Complex Glomerulonephritis en_US
dc.title Severe acute kidney injury induced by crescentic glomerulonephritis in a child with infective endocarditis en_US
dc.type Article en_US
dc.identifier.volume 64 en_US
dc.identifier.issue 5 en_US
dc.identifier.startpage 919 en_US
dc.identifier.endpage 924 en_US
dc.authorid YUKSEL, SELCUK/0000-0001-9415-1640
dc.identifier.doi 10.24953/turkjped.2021.4397
dc.relation.publicationcategory Makale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı en_US
dc.authorscopusid 57213146089
dc.authorscopusid 8514659100
dc.authorscopusid 6603227515
dc.authorscopusid 36657292800
dc.authorscopusid 55579588300
dc.authorscopusid 57210550564
dc.authorscopusid 56600861000
dc.authorwosid YUKSEL, SELCUK/C-5473-2015
dc.department-temp [Yilmaz, Neslihan; Girisgen, Ilknur; Becerir, Tulay] Pamukkale Univ, Fac Med, Dept Pediat Nephrol, Denizli, Turkey; [Yuksel, Selcuk] Pamukkale Univ, Fac Med, Dept Pediat Rheumatol & Pediat Nephrol, Denizli, Turkey; [Gurses, Dolunay; Yilmaz, Munevver] Pamukkale Univ, Fac Med, Dept Pediat Cardiol, Denizli, Turkey; [Ufuk, Furkan] Pamukkale Univ, Fac Med, Dept Pediat Radiol, Denizli, Turkey; [Gulten, Gulsun] Pamukkale Univ, Fac Med, Dept Pathol, Denizli, Turkey en_US
dc.identifier.pmid 36305443 en_US
dc.identifier.scopus 2-s2.0-85140297680 en_US
dc.identifier.trdizinid 1139238 en_US
dc.identifier.wos WOS:000877680300014 en_US

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