title: Parvovirus B19-induced multisystemic vasculitis and acute endocapillary proliferative glomerulonephritis in a child.
abstract: A 10-year-old girl was admitted with fever, cough, maculopapular rash, hemoptysis, dark-colored urine, edema, multiple lymphadenopathies, and hepatosplenomegaly. She developed acute glomerulonephritis during the course of these complex clinical features. Laboratory data showed hematuria, proteinuria, and hypocomplementemia. Serological tests showed positive human parvovirus B19 (HPVB19)-specific immunoglobin M (IgM) and HPVB19 DNA was detected in the patient's serum using polymerase chain reaction (PCR). Renal biopsy revealed acute endocapillary proliferative glomerulonephritis (AEPGN) with coarse granular C3 depositions in a "starry sky pattern," which is more peculiar to poststreptococcal glomerulonephritis. Electron microscopy showed subendothelial and small hump-shaped subepithelial electron-dense deposits in glomerular capillary walls. There was no evidence of either any mycobacterial, staphylococcal, or streptococcal infection, and the diagnosis of Goodpasture syndrome and connective tissue disorders was excluded during clinical and laboratory investigations. A diagnosis of HPVB19-induced pleuropneumonitis and glomerulonephritis was made. Through a literature search there was no documented pediatric case of AEPGN induced by HPVB19, and this case represents, to our knowledge, the first time that a direct relationship between parvovirus infection and AEPGN has been demonstrated in a child.
authors.affiliation: Department of Pediatric Nephrology, Baskent University, Faculty of Medicine, Ankara, Turkey. hales1972@yahoo.com
authors.forename: Hale
authors.initials: H
authors.lastname: Sakalli
authors.forename: Esra
authors.initials: E
authors.lastname: Baskin
authors.forename: Umut Selda
authors.initials: US
authors.lastname: Bayrakçi
authors.forename: Engin
authors.initials: E
authors.lastname: Melek
authors.forename: Nurcan
authors.initials: N
authors.lastname: Cengiz
authors.forename: Binnaz Handan
authors.initials: BH
authors.lastname: Ozdemir
mesh_terms: D000208:Acute Disease; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D005921:Glomerulonephritis / Q000175:diagnosis / Q000821:virology*; D006801:Humans; D010322:Parvoviridae Infections / Q000175:diagnosis / Q000821:virology*; D016732:Parvovirus B19, Human / Q000302:isolation & purification*; D014657:Vasculitis / Q000175:diagnosis / Q000821:virology*