Favorable outcome in a case of Mycoplasma pneumoniae-associated crescentic glomerulonephritis

Pediatr Nephrol. 2010 Sep;25(9):1765-9. doi: 10.1007/s00467-010-1491-4. Epub 2010 Mar 25.

Abstract

Mycoplasma pneumoniae-associated nephritis has been reported in children with various pathological findings. It nevertheless remains an uncommon disease and, within this clinical context, endo-and extracapillary glomerulonephritis in a child has never been described. We report here a case of a 3-year-old girl diagnosed with severe crescentic glomerulonephritis associated with M. pneumoniae infection who presented with nephrotic syndrome and impaired renal function. The serum C3 complement level was initially low but returned to normal after 1 month. Two courses of three methylprednisolone pulses were administered in association with plasmapheresis and, secondarily, mycophenolate mophetil. This treatment regimen led to disease remission and a favorable renal outcome at the 6-month follow-up. However, the treatment guidelines in this situation remain debatable.

Publication types

  • Case Reports

MeSH terms

  • Biomarkers / blood
  • Child, Preschool
  • Complement C3-C5 Convertases / metabolism
  • Drug Administration Schedule
  • Female
  • Glomerulonephritis / immunology
  • Glomerulonephritis / microbiology
  • Glomerulonephritis / therapy*
  • Humans
  • Immunosuppressive Agents / administration & dosage*
  • Methylprednisolone / administration & dosage*
  • Mycophenolic Acid / administration & dosage
  • Mycophenolic Acid / analogs & derivatives*
  • Mycoplasma pneumoniae / isolation & purification*
  • Nephrotic Syndrome / microbiology
  • Nephrotic Syndrome / therapy
  • Plasmapheresis*
  • Pneumonia, Mycoplasma / complications*
  • Proteinuria / microbiology
  • Proteinuria / therapy
  • Pulse Therapy, Drug
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • Immunosuppressive Agents
  • Complement C3-C5 Convertases
  • Mycophenolic Acid
  • Methylprednisolone