Immune Complex-Mediated Crescentic Glomerulonephritis

Abstract

Immune complex-mediated Glomerulonephritis (GN) comprises a group of disorders including Immunoglobulin A (IgA) nephropathy, IgA vasculitis, lupus nephritis, infection-related GN {poststreptococcal, Hepatitis C Virus (HCV)}, and fibrillary GN with polyclonal Ig deposits. Infection-Related Glomerulonephritis (IRGN) is an immune complex-mediated injury which is triggered by an infection other than renal causes. With new evolving histopathological variants such as C3 Glomerulonephritis (C3GN), it can be challenging to consultants in both diagnostic and management aspects in differentiating it from IRGN. It is seen to occur alongside infection in adults with a greater risk of disease progression to End-Stage Renal Disease (ESRD). Here, the authors report a case of 33- year-old male who presented with gastrointestinal and urinary symptoms. Patient was initially diagnosed as infective diarrhea with Acute Kidney Injury (AKI), and on further evaluation, renal biopsy was suggestive of immune-complex mediated crescentic GN. Patient was treated with steroids and there was an improving trend of renal function and positive outcome after treatment, with an overall good prognosis. Aetiology of this immune-complex mediated crescentic GN is however unclear due to similarities between Postinfectious Glomerulonephritis (PIGN) and C3 glomerulopathy pathologically.