title: Gemella sanguinis endocarditis with c-ANCA/anti-PR-3-associated immune complex necrotizing glomerulonephritis with a 'full-house' pattern on immunofluorescence microscopy.
abstract: A 67-year-old man was evaluated for haematuria, with a rising creatinine level from 88 to 906 µmol/L and positive c-anti-neutrophil cytoplasm antibody (ANCA)/anti-proteinase 3 (anti-PR3). A kidney biopsy revealed necrotizing glomerulonephritis with a 'full-house' pattern on immunofluorescence microscopy. Echocardiography and blood cultures growing Gemella sanguinis diagnosed endocarditis. Dialysis was required for a month. Three months later, following valve replacement, glucocorticoids and 2 months of antibiotic therapy, the creatinine level decreased to 62 µmol/L and c-ANCA/anti-PR3 disappeared. This first case of c-ANCA/anti-PR3 positive glomerulonephritis with a 'full-house' immunofluorescence pattern due to bacterial endocarditis underlines the importance of ruling out infection with ANCA positivity or kidney biopsy suggestive of lupus nephritis.
authors.affiliation: Service of Nephrology , CHUQ-Hôtel-Dieu de Québec , Quebec , Canada.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Rousseau-Gagnon
authors.affiliation: Service of Pathology , CHUQ-Hôtel-Dieu de Québec , Quebec , Canada.
authors.forename: Julie
authors.initials: J
authors.lastname: Riopel
authors.affiliation: Service of Infectious Diseases , CHUQ-Hôtel-Dieu de Québec , Quebec , Canada.
authors.forename: Anne
authors.initials: A
authors.lastname: Desjardins
authors.affiliation: Service of Nephrology , IUCPQ , Quebec , Canada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Garceau
authors.affiliation: Service of Nephrology , CHUQ-Hôtel-Dieu de Québec , Quebec , Canada.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Agharazii
authors.affiliation: Service of Nephrology , CHUQ-Hôtel-Dieu de Québec , Quebec , Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Desmeules
keywords: ANCA; Gemella spp.; endocarditis; glomerulonephritis