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. 2015:2015:649763.
doi: 10.1155/2015/649763. Epub 2015 Dec 27.

Necrotizing ANCA-Positive Glomerulonephritis Secondary to Culture-Negative Endocarditis

Sophie Van Haare Heijmeijer  1 , Dunja Wilmes  2 , Selda Aydin  3 , Caroline Clerckx  1 , Laura Labriola  4
Affiliations

Necrotizing ANCA-Positive Glomerulonephritis Secondary to Culture-Negative Endocarditis

Sophie Van Haare Heijmeijer et al. Case Rep Nephrol. 2015.

Abstract

Infective endocarditis (IE) and small-vessel vasculitis may have similar clinical features, including glomerulonephritis. Furthermore the association between IE and ANCA positivity is well documented, making differential diagnosis between IE- and ANCA-associated vasculitis particularly difficult, especially in case of culture-negative IE. We report on one patient with glomerulonephritis secondary to culture-negative IE caused by Bartonella henselae which illustrates this diagnostic difficulty.

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Figures

Figure 1
Figure 1
Kidney biopsy findings (Masson's trichrome, 46x): glomeruli showing foci of necrosis (arrows) with a recent cellular crescent (arrowhead).
Figure 2
Figure 2
Immunofluorescence shows subepithelial granular staining for IgM and C3 and parietal granular staining for C1q.
See this image and copyright information in PMC

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