Nephrotic Syndrome: Beyond Common Causes.

IF 2.4 4区 医学 Q2 UROLOGY & NEPHROLOGY
Nephrology Pub Date : 2025-04-01 DOI:10.1111/nep.70035
Humam Hazim, Ryan Horn, Ashwati Krishnan Varikara, Joanna Mesure, Bobby Chacko
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Abstract

We report the case of a 38-year-old Caucasian man with well-controlled HIV on antiretroviral therapy who developed nephrotic syndrome. The patient presented with a maculopapular rash, lymphadenopathy, oral lesions, nasal congestion and bilateral pitting oedema. Laboratory tests revealed hypoalbuminemia, nephrotic range proteinuria and abnormal liver function. Further investigations confirmed secondary syphilis with positive Treponema pallidum serology. Kidney biopsy showed membranous nephropathy. Treatment with Benzathine benzylpenicillin resulted in a rapid resolution of nephrotic syndrome, improved liver function and normalisation of serum albumin levels. This case highlights the rare but recognised link between syphilis and nephrotic syndrome, emphasising the importance of prompt diagnosis and antibiotic treatment to prevent the need for more aggressive treatments. Syphilis can cause a variety of systemic manifestations, and co-infection with HIV is common due to their shared transmission route. Healthcare providers must remain vigilant in considering syphilis as a potential cause of nephrotic syndrome in HIV-positive patients, particularly when other clinical and laboratory features suggest its presence.

肾病综合征:超越常见原因。
我们报告的情况下,38岁的高加索人与良好控制艾滋病毒抗逆转录病毒治疗谁发展肾病综合征。患者表现为黄斑丘疹、淋巴结病变、口腔病变、鼻塞和双侧凹陷性水肿。实验室检查显示低白蛋白血症,肾病范围蛋白尿和肝功能异常。进一步调查证实继发性梅毒伴梅毒螺旋体血清学阳性。肾活检显示膜性肾病。用苄星青霉素治疗导致肾病综合征的快速解决,肝功能的改善和血清白蛋白水平的正常化。该病例突出了梅毒和肾病综合征之间罕见但公认的联系,强调了及时诊断和抗生素治疗的重要性,以防止需要更积极的治疗。梅毒可引起多种全身性表现,由于其共同的传播途径,与HIV合并感染是常见的。医疗保健提供者必须保持警惕,考虑梅毒作为艾滋病毒阳性患者肾病综合征的潜在原因,特别是当其他临床和实验室特征表明它的存在。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Nephrology
Nephrology 医学-泌尿学与肾脏学
CiteScore
4.50
自引率
4.00%
发文量
128
审稿时长
4-8 weeks
期刊介绍: Nephrology is published eight times per year by the Asian Pacific Society of Nephrology. It has a special emphasis on the needs of Clinical Nephrologists and those in developing countries. The journal publishes reviews and papers of international interest describing original research concerned with clinical and experimental aspects of nephrology.
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