Post-dengue acute proliferative glomerulonephritis: a rare association of two common diseases

• Published in: Pathology Vol. 47; pp. S66 - S67
• Main Authors: Khoo, Joon-Joon, Ramlan, Jasmi, Cheong, Wai-Seng, Hooi, Lai-Seong
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 2015
• DOI: 10.1097/01.PAT.0000461498.40364.e6
• ISSN: 0031-3025

Acute proliferative glomerulonephritis (AGN) may follow streptococcal or non-streptococcal infections that include bacterial, viral, fungal and parasites. Dengue infection is a mosquito-borne viral disease causing acute febrile illness that may be complicated by dengue haemorrhagic fever and shock syndrome. Dengue associated AGN in humans, however, has not been reported. A 36-year-old man presented with oedema and frothy urine for 3 days. He had proteinuria of nephrotic range with microscopic haematuria. Renal function was normal and investigations: ASOT, ANA, VDRL and hepatitis screen were non-reactive. Renal biopsy showed acute proliferative glomerulonephritis with hump-like fuchsinophilic deposits at the subepithelial location along the glomerular capillaries. There were associated IgG and C3 immune deposits. Three weeks prior to this presentation, he was admitted for dengue with positive serology NS-1, which he recovered uneventfully. The latent interval between the preceding infection and onset of renal symptoms of AGN can range from 1 to 6 weeks. AGN is immunologically mediated disease and requires development of antibodies after an infection. It has been hypothesised that dengue virus infection elicits an immune response to the viral antigens. Immune-complex deposition and proliferative lesions were demonstrated in glomeruli of experimental mouse models infected with dengue infection.