title: A case report of varicella-zoster virus infection associated glomerulonephritis and encephalitis.
abstract: 15-year-old boy was admitted with nephritic and nephrotic syndrome, renal dysfunction and decreased  serum C3, who suffered from varicella for two months. His renal histopathology revealed endocapillary  proliferative glomerulonephritis with podocytes proliferation and severe tubular injury by light microscopy.  Direct immunofluorescence showed global granular deposition of IgG, IgA, IgM, C3, C1q and fibrinogen in mesangium  and along glomerular capillary wall. Electron microscopic examination showed electron-dense deposits in multiple  sites of glomeruli. Furthermore, specific serum IgM antibodies against varicella-zoster virus (VZV) were  detected. VZV antigen and mRNA were demonstrated in glomerular and tubular epithelial cells by  immunohistochemical staining and in-situ hybridization. Virus particles and virus inclusions were identified by  electron microscopy and special staining (Methylene Blue and Eosion staining or Mann staining). The patient also  experienced epileptic episodes and his brain MRI and electroencephalogram indicated herpes encephalitis with  secondary epilepsy. Therefore, the diagnosis of VZV-associated glomerulonephritis and encephalitis was  established. This is the first case of VZV-associated glomerulonephritis with renal histopathological evidence  using in situ hybridization technique.
authors.affiliation: Department of Nephrology, China-Japan Friendship Hospital, Beijing 100029, China. cliff-zou@sina.com
authors.forename: Gu-ming
authors.initials: GM
authors.lastname: Zou
authors.forename: Yi-pu
authors.initials: YP
authors.lastname: Chen
authors.forename: Wen-ge
authors.initials: WG
authors.lastname: Li
mesh_terms: D000293:Adolescent; D002644:Chickenpox / Q000150:complications*; D020804:Encephalitis, Varicella Zoster / Q000150:complications*; D005921:Glomerulonephritis / Q000150:complications* / Q000821:virology; D014645:Herpesvirus 3, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male