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Yeungnam Univ J Med > Volume 34(1); 2017 > Article
Yeungnam University Journal of Medicine 2017;34(1):140-145.
DOI: https://doi.org/10.12701/yujm.2017.34.1.140    Published online June 30, 2017.
C-ANCA-positive glomerulonephritis associated with subacute infective endocarditis caused by Bartonella infection
Min Jeong Kim, Ha Nee Jang, Tae Won Lee, Hyun Seop Cho, Se Ho Chang, Hyun Jung Kim
1Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea. kimhjyh@naver.com
2Institute of Health Sciences, Gyeongsang National University, Jinju, Korea.
Abstract
Glomerulonephritis (GN) is sometimes associated with infective endocarditis (IE). Bartonella endocarditis is difficult to diagnose because it is rare and cannot be detected by blood culture. This is the first report of cytoplasmic anti-neutrophil cytoplasmic antibody-positive subacute endocarditis-associated GN caused by Bartonella infection in South Korea. A 67-year-old man was hospitalized due to azotemia. He complained of weight loss and anorexia for 6 months. A diagnosis of IE was made based upon echocardiographic detection of vegetations on the mitral and aortic valves and a Bartonella antibody titer of 1:2,048. Renal histology identified focal crescentic GN. Azotemia and proteinuria improved after doxycycline and rifampin treatment combining with steroid therapy.
Key Words: ANCA-associated glomerulonephritis, Bartonella, Infectious endocarditis
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