An unusual case of Plasmodium vivax malaria monoinfection associated with crescentic glomerulonephritis: a need for vigilance.
Plasmodium vivax infection is increasingly a major public health burden and the second most frequent human malaria. Higher levels of clinical severity and chloroquine resistance are major factors responsible for such increases. Malarial glomerular injury is uncommon and mainly observed in Plasmodium malariae-infected patients. Occasionally, transient immune complex-mediated glomerulonephritis is associated with Plasmodium falciparum infection. Coexistent crescentic glomerulonephritis and vivax malaria have not previously been reported. We report a fatal case of P. vivax malaria, who presented with acute renal failure. P. vivax monoinfection status was diagnosed with peripheral blood smear and rapid antigen test. Further evaluation for renal failure related to systemic illness and immunological markers were inconclusive. He was treated with antimalarial drugs, hemodialysis, and supportive therapy. Renal biopsy performed for nonrecovering renal failure reveled crescentic glomerulonephritis. This case highlights the need to thoroughly search for malaria-associated crescentic glomerulonephritis using renal biopsy after nonrecovering renal failure.
Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center-Dr. H L Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Civil Hospital Campus, Asarwa, Ahmedabad, 380016, Gujarat, India. drmohan610@yahoo.com
Mohan P
MP
Patel
Vivek B
VB
Kute
Manoj R
MR
Gumber
Dinesh N
DN
Gera
Pankaj R
PR
Shah
Himanshu V
HV
Patel
Hargovind L
HL
Trivedi
Aruna V
AV
Vanikar
D000293:Adolescent; D000962:Antimalarials / Q000008:administration & dosage; D001706:Biopsy; D017809:Fatal Outcome; D005921:Glomerulonephritis / Q000150:complications / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D016780:Malaria, Vivax / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D010966:Plasmodium vivax / Q000472:pathogenicity*; D051437:Renal Insufficiency / Q000209:etiology / Q000473:pathology
D000962:Antimalarials