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Staphylococcus-associated acute glomerulonephritis in a patient with dermatomyositis
  1. Rasmi Ranjan Sahoo,
  2. Sourav Pradhan,
  3. Akhil Pawan Goel and
  4. Anupam Wakhlu
  1. Department of Clinical Immunology and Rheumatology, King George's Medical University, Lucknow, Uttar Pradesh, India
  1. Correspondence to Dr Anupam Wakhlu; anupamwakhlu{at}gmail.com

Abstract

Staphylococcus-associated glomerulonephritis (SAGN) occurs as a complication of staphylococcal infection elsewhere in the body. Dermatomyositis (DM) can be associated with glomerulonephritis due to the disease per se. We report a case of a 40-year-old male patient with DM who presented with acute kidney injury, and was initially pulsed with methylprednisolone for 3 days, followed by dexamethasone equivalent to 1 mg/kg/day prednisolone. He was subsequently found to have SAGN on kidney biopsy along with staphylococcus bacteraemia and left knee septic arthritis. With proof of definitive infection, intravenous immunoglobulin 2 g/kg over 2 days was given and steroids were reduced. He was treated with intravenous vancomycin. With treatment, the general condition of the patient improved. On day 38, he developed infective endocarditis and died of congestive heart failure subsequently. Undiagnosed staphylococcal sepsis complicating a rheumatological disease course can lead to complications like SAGN, infective endocarditis and contribute to increased morbidity and mortality, as is exemplified by our case.

  • connective tissue disease
  • acute renal failure

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Footnotes

  • Twitter @RasmiKGMU

  • Contributors RRS: Data acquisition, drafting of manuscript and final approval. SP: Data acquisition, critical revision and final approval of the manuscript. APG: Data acquisition, critical revision and final approval of the manuscript. AW: Data interpretation, critical revision and final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer-reviewed.