Pediatric Nephrology

, Volume 27, Issue 11, pp 2149–2152

Methicillin-resistant Staphylococcus aureus-related glomerulonephritis in a child

  • Takahisa Kimata
  • Shoji Tsuji
  • Ken Yoshimura
  • Hiroyasu Tsukaguchi
  • Kazunari Kaneko
Brief Report

DOI: 10.1007/s00467-012-2229-2

Cite this article as:
Kimata, T., Tsuji, S., Yoshimura, K. et al. Pediatr Nephrol (2012) 27: 2149. doi:10.1007/s00467-012-2229-2

Abstract

Background

Methicillin-resistant Staphylococcus aureus-associated glomerulonephritis (MRSA-GN), a syndrome in which superantigens play an important role in the pathogenesis of the infection, has been well described in adult patients but not previously recognized in children.

Case Diagnosis/Treatment

We report the case of a 6-year-old girl with MRSA-GN. She presented multiple malformations, including tracheal stenosis necessitating tracheotomy. She was admitted to our hospital because of acute pneumonia caused by a MRSA infection and was found to have proteinuria and abnormal renal function. MRSA was detected in her sputum, and this MRSA isolate produced toxic shock syndrome toxin-1, which acts as a superantigen and stimulates Vβ2+ T cells. A blood test revealed that the number of circulating Vβ2+ T cells expressing CD45RO, a marker of activation, was increased along with a concomitant elevation in the levels of serum immunoglobulins. Both are hallmarks of MRSA-GN. The eradication of MRSA using appropriate antibiotics resulted in the disappearance of the proteinuria; in contrast, corticosteroid treatment failed. To the best of our knowledge, this is the youngest patient to be diagnosed with MRSA-GN.

Conclusions

In summary, there should be a high index of suspicion for MRSA-GN, even in the very young, in order to avoid the unnecessary use of immune suppressants in this context.

Keywords

Methicillin-resistant Staphylococcus aureusMRSAToxic shock syndrome toxin-1SuperantigenGlomerulonephritis

Copyright information

© IPNA 2012

Authors and Affiliations

  • Takahisa Kimata
    • 1
  • Shoji Tsuji
    • 1
  • Ken Yoshimura
    • 1
  • Hiroyasu Tsukaguchi
    • 2
  • Kazunari Kaneko
    • 1
  1. 1.Department of PediatricsKansai Medical UniversityHirakata-shiJapan
  2. 2.2nd Department of Internal MedicineKansai Medical UniversityHirakata-shiJapan