Rapidly progressive glomerulonephritis in tuberculosis

• Published in: Saudi journal of kidney diseases and transplantation Vol. 25; no. 4; pp. 872 - 875
• Main Authors: Waikhom, Rajesh, Sarkar, Dipankar, Bennikal, Mahesh, Pandey, Rajendra
• Format: Journal Article
• Language: English
• Published: Riyadh, Saudi Arabia Saudi Center for Organ Transplantation 01.07.2014; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer Medknow Publications
• Subjects: Antitubercular Agents - therapeutic use; Biopsy; Care and treatment; Case studies; Child; Complications and side effects; Diagnosis; Disease Progression; Diseases; Edema; Glomerulonephritis; Glomerulonephritis - diagnosis; Glomerulonephritis - microbiology; Glomerulonephritis - therapy; Humans; Kidney glomerulus; Male; Renal Dialysis; Risk factors; Time Factors; Treatment Outcome; Tuberculosis; Tuberculosis, Lymph Node - diagnosis; Tuberculosis, Lymph Node - drug therapy; Tuberculosis, Lymph Node - microbiology; Tuberculosis, Miliary - diagnosis; Tuberculosis, Miliary - drug therapy; Tuberculosis, Miliary - microbiology; Tuberculosis, Pulmonary - diagnosis; Tuberculosis, Pulmonary - drug therapy; Tuberculosis, Pulmonary - microbiology; Tuberculosis, Renal - diagnosis; Tuberculosis, Renal - drug therapy; Tuberculosis, Renal - microbiology; Urine; الأمراض; التشخيص; التهاب كبيبات الكلى; الكلى; المضاعفات; مرض السل; India
• ISSN: 1319-2442; 2320-3838
• DOI: 10.4103/1319-2442.135187

Renal involvement in tuberculosis occurs due to lympho-hematogenous dissemination. However, glomerular involvement is an uncommon event. Crescentic nephritis complicating tuberculosis is a therapeutic dilemma and weighs the risk of worsening the infection after immunosuppressive therapy. We present here a case of miliary tuberculosis with immune complex crescentic nephritis with advanced renal injury requiring renal replacement therapy. A diagnosis of miliary tuberculosis was made on the basis of positive sputum AFB, lymph node biopsy showing caseating granulomas and urinary polymerase chain reaction being positive for mycobacterial antigens. The patient recovered renal function with anti-tuberculous therapy without requiring immunosuppressive therapy.