title: Post-MRSA infection glomerulonephritis with marked Staphylococcus aureus cell envelope antigen deposition in glomeruli.
abstract: A 48-year-old male developed massive proteinuria and renal dysfunction after pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA) infection. Examination of a renal biopsy specimen by light microscopy showed severe mesangiocapillary proliferative glomerulonephritis with fibrocellular crescents. Immunofluorescence microscopy showed weak linear staining for immunoglobulin G (IgG), while both the peripheral and mesangial lesions stained for IgA and C3. Immunostaining for a possible antigen related to post-MRSA infection glomerulonephritis, using monoclonal antibody S1D6, revealed marked deposition of S.aureus cell envelope antigen in the glomeruli. Electron-dense deposits were observed in both the subendothelial and the mesangial areas. Focal subendothelial widening accompanied with monocytes or foam cell infiltration was also seen. The findings reflect a typical post-MRSA infection glomerulonephritis caused by S.aureus cell envelope antigen.
authors.affiliation: Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba City, Ibaraki, Japan.
authors.forename: Hirayasu
authors.initials: H
authors.lastname: Kai
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hagiwara
authors.forename: Keigyou
authors.initials: K
authors.lastname: Yoh
authors.forename: Kouichi
authors.initials: K
authors.lastname: Hirayama
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Yamagata
authors.forename: Shoji
authors.initials: S
authors.lastname: Ohba
authors.forename: Michio
authors.initials: M
authors.lastname: Nagata
authors.forename: Akio
authors.initials: A
authors.lastname: Koyama
mesh_terms: D000942:Antigens, Bacterial / Q000378:metabolism*; D003176:Complement C3 / Q000378:metabolism; D005920:Glomerular Mesangium / Q000378:metabolism* / Q000473:pathology; D015432:Glomerulonephritis, Membranoproliferative / Q000209:etiology / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007070:Immunoglobulin A; D007074:Immunoglobulin G / Q000378:metabolism; D008297:Male; D016106:Methicillin Resistance / Q000187:drug effects; D008875:Middle Aged; D011023:Pneumonia, Staphylococcal / Q000150:complications / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D011507:Proteinuria / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D013211:Staphylococcus aureus
chemical_list: D000942:Antigens, Bacterial; D003176:Complement C3; D007070:Immunoglobulin A; D007074:Immunoglobulin G