Abstract
An 11-year old girl presented with pneumonia, pleural effusion, hematuria and red blood cell casts. The blood pressure, serum electrolytes, immunoglobulins and C3 concentrations were within normal range. Sputum cultures were negative for M.pneumoniae. The ASO titers were less than 200 Todd U. Cold agglutinin titers were 1/64 on admission and 1/256 on Day 9. Complement fixation titers for M.pneumoniae were negative on admission; subsequent titers measured on several occasions were 1/128. A thoracentesis revealed straw-colored fluid;gram stain and cultures of the pleural fluid for bacteria, viruses, fungi and acid-fast bacilli were negative. A percutaneous renal biopsy revealed an acute glomerulonephritis by light microscopy; immunofluorescent studies showed deposits of IgG, C3 and mycoplasma antigen along the glomerular capillary walls and in the mesangium; subendothelial and subepithelial deposits were seen by electron microscopy. Circulating immune complexes, 19S or larger, have been demonstrated in patienta with acute respiratory illness caused by M.pneumoniae when clinical signs were most pronounced.
This is the first report of immune complexes(antigen-antibody and C3)deposited in the kidney of a patient with M.pneumoniae infection and glomerulonephritis.
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Vitullo, B., O'regan, S. & Kaplan, B. MYCOPLASMA PNEUMONIA, PLEURAL EFFUSION AND ACUTE GLOMERULONEPHRITIS. Pediatr Res 11, 559 (1977). https://doi.org/10.1203/00006450-197704000-01136
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DOI: https://doi.org/10.1203/00006450-197704000-01136