DOI: 10.12890/2016_000447
A Rare Presentation of Leptospirosis
Authors
filipadcs@gmail.com
Keywords
leptospirosis, acute renal failure, nephrotic syndromeAbstract
Leptospirosis has a wide spectrum of clinical manifestations. Acute renal failure, an important complication, generally involves interstitial and tubular damage. We describe the case of a 42-year-old man who was admitted with fever, back pain and periorbital oedema. He had hypertension, thrombocytopenia, acute renal failure, hypoalbuminaemia, hypertriglyceridaemia and proteinuria >4.00 g/l. The renal biopsy showed mesangioproliferative glomerulonephritis. Due to the epidemiological context and clinical picture, ceftriaxone was started with rapid clinical improvement. Blood PCR for leptospira came back positive. The presentation of leptospirosis as nephrotic syndrome is rare and this diagnosis should be considered before performing a renal biopsy.
References
- Daher Ede F, Abreu KL, da Silva Junior GB. Leptospirosis-associated acute kidney injury. J Bras Nefrol 2010;32:400–407.
- Abdulkader RC, Silva MV. The kidney in leptospirosis. Pediatr Nephrol 2008;23:2111–2120.
- Kshirsagar PP, Sonavane AD, Doshi AC, Teltumbde U, Mandalik S. Atypical presentation of leptospirosis. J Assoc Physicians India 2010;28:114–115.
- Seyit K, Sezai V, Aytaç K, Osman E, Leyla K, Hamit B et al. A case of leptospirosis presenting with nephrotic syndrome, acute renal failure and thrombocytopenia. Istanbul Tip Fakultesi Dergisi Cilt 2009;2:25–28.
- Visith S, Kearkiat P. Nephropathy in leptospirosis. J Postgrad Med 2005;51:184–188.
- Becj L, Bomback A, Choi M, Holzman L, Mariani L et al. KDIGO Clinical Practice Guideline for Glomerulonephritis. Am J Kidney Dis 2013;62:403–441.