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Case Reports
. 2024 Sep 6:2024:4181660.
doi: 10.1155/2024/4181660. eCollection 2024.

ANCA-Negative Pauci-Immune Glomerulonephritis Associated with Bartonella Endocarditis

Camille Ng  1 , Angela Penney  1 , Rojin Sharaflari  1 , Akash Pathak  1 , John H Howard Iii  2 , Kuang-Yu Jen  3
Affiliations
Case Reports

ANCA-Negative Pauci-Immune Glomerulonephritis Associated with Bartonella Endocarditis

Camille Ng et al. Case Rep Nephrol. .

Abstract

Kidney complications can occur due to infective endocarditis, one of which is glomerulonephritis. Most often, an immune complex or complement-mediated glomerulonephritis is seen on kidney biopsy. In a minor subset of cases, pauci-immune glomerulonephritis may be present. Most often, such patients will demonstrate the presence of antineutrophil cytoplasmic antibodies (ANCA) on serologic testing. A growing number of cases of ANCA-associated glomerulonephritis due to Bartonella endocarditis have been reported. This type of endocarditis can present diagnostic difficulties given that these patients are often culture negative. Herein, we report a challenging case of ANCA-negative pauci-immune glomerulonephritis showing florid crescents on biopsy that was associated with Bartonella endocarditis.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Glomerular findings on kidney biopsy: (a) periodic acid-Schiff stain showing two glomeruli with large cellular crescents (200x magnification); (b) Masson trichrome stain showing a glomerulus with a large cellular crescent in association with fibrinoid necrosis from a necrotizing lesion (200x magnification). Note the background acute tubular epithelial cell injury.
Figure 2
Figure 2
Timeline of clinical course.
See this image and copyright information in PMC

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