title: Staphylococcus-related glomerulonephritis and poststreptococcal glomerulonephritis: why defining "post" is important in understanding and treating infection-related glomerulonephritis.
abstract: A spate of recent publications describes a newly recognized form of glomerulonephritis associated with active staphylococcal infection. The key kidney biopsy findings, glomerular immunoglobulin A (IgA) deposits dominant or codominant with IgG deposits, resemble those of IgA nephritis. Many authors describe this condition as "postinfectious" and have termed it "poststaphylococcal glomerulonephritis." However, viewed through the prism of poststreptococcal glomerulonephritis, the prefix "post" in poststaphylococcal glomerulonephritis is historically incorrect, illogical, and misleading with regard to choosing therapy. There are numerous reports describing the use of high-dose steroids to treat poststaphylococcal glomerulonephritis. The decision to use steroid therapy suggests that the treating physician believed that the dominant problem was a postinfectious glomerulonephritis, not the infection itself. Unfortunately, steroid therapy in staphylococcus-related glomerulonephritis can precipitate severe staphylococcal sepsis and even death and provides no observable benefits. Poststreptococcal glomerulonephritis is an authentic postinfectious glomerulonephritis; poststaphylococcal glomerulonephritis is not. Making this distinction is important from the perspective of history, pathogenesis, and clinical management.
authors.affiliation: Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Glassock
authors.affiliation: Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Anthony
authors.initials: A
authors.lastname: Alvarado
authors.affiliation: Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Jason
authors.initials: J
authors.lastname: Prosek
authors.affiliation: Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Courtney
authors.initials: C
authors.lastname: Hebert
authors.affiliation: Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Samir
authors.initials: S
authors.lastname: Parikh
authors.affiliation: Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Anjali
authors.initials: A
authors.lastname: Satoskar
authors.affiliation: Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Tibor
authors.initials: T
authors.lastname: Nadasdy
authors.affiliation: Renal Division, Brigham and Women's Hospital, Boston, MA.
authors.forename: John
authors.initials: J
authors.lastname: Forman
authors.affiliation: Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Brad
authors.initials: B
authors.lastname: Rovin
authors.affiliation: Ohio State University Wexner Medical Center, Columbus, OH. Electronic address: lee.hebert@osumc.edu.
authors.forename: Lee A
authors.initials: LA
authors.lastname: Hebert
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005921:Glomerulonephritis / Q000145:classification* / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus; D013203:Staphylococcal Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D013211:Staphylococcus aureus; D013290:Streptococcal Infections / Q000150:complications*; D009626:Terminology as Topic
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents
keywords: Post-staphylococcal glomerulonephritis; kidney biopsy; latent period; medical error; nomenclature; nosology; post-infectious glomerulonephritis; renal disease; steroid treatment