An Unusual Cause of Nephrotic Syndrome Accompanying Hematuria: Endocarditis-associated Glomerulonephritis

Abstract

Endocarditis-associated glomerulonephritis (EGN), a specific sub-subtype of post-infectious glomerulonephritis (PIGN) is very rare in children. Nephrotic syndrome is a rare presentation for EGN with a reported frequency of 6%. In this case, an 8-year-old girl patient presented with nephrotic syndrome accompanying hematuria is mentioned. She was hospitalized with fever, mild azotemia, acute phase elevation and hypocomplementemia. Aggregatibacter Actinomycetemcomitans has grown in blood culture. Echocardiogram revealed third-degree tricuspid regurgitation and vegetations on the tricuspid valve. She was commenced on ceftriaxone therapy with a diagnose of EGN. At the end of the six-week treatment, the patient was discharged with normal laboratory values except for non-nephrotic proteinuria. Cardiac vegetations had completely disappeared. PIGN is still an important cause of morbidity for developing countries. EGN is rarely seen especially in childhood with the presence of predisposing conditions. With timely diagnosis and correct treatment, satisfactory results are possible in terms of kidney health.