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Favorable course of leptospirosis and hantavirus-induced acute tubulointerstitial nephritis under corticosteroid treatment

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Abstract

Background

We present two children with acute tubulointerstitial nephritis (ATIN) caused by leptospirosis in a 12-year-old boy and hantavirus in a 10-year-old girl. The role of glucocorticoids in the management of ATIN triggered by infectious agents is unclear.

Case-diagnosis/treatment

Both children were hospitalized with jaundice, elevated serum creatinine, and thrombocytopenia. There was no oliguria or hypertension. Urine analysis revealed tubular proteinuria. Kidney biopsy was performed on one patient and showed tubulointerstitial inflammation with mild mesangial proliferation. Both patients were treated with glucocorticoids in view of deteriorating kidney function with respective serum creatinine values of 5.2 and 4.1 mg/dl. Both children exhibited an excellent clinical and biochemical response to treatment. Neither of the patients required dialysis. Positive serology test results indicated a recent leptospirosis and hantavirus infection.

Conclusions

Leptospirosis and hantavirus associated ATIN share common clinical and biochemical features. Due to the low incidence in Europe these infectious causes of kidney dysfunction may be overlooked. Glucocorticoids may be considered in the management of ATIN.

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Data Availability

All data underlying the results are available as part of the article.

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Authors and Affiliations

  1. Department of Paediatric Nephrology and Rheumatology, Ghent University Hospital, ERKNet Center, Corneel Heymanslaan 10, 9000, Ghent, Belgium

    Annelies Matthys, Jo Dehoorne & Agnieszka Prytuła

  2. Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium

    Annelies Matthys, Jo Dehoorne, Petra Schelstraete & Agnieszka Prytuła

  3. Department of Pathological Anatomy, Ghent University Hospital, Ghent, Belgium

    Amélie Dendooven

  4. Department of Paediatric Pneumology and Infectious Diseases, Ghent University Hospital, Ghent, Belgium

    Petra Schelstraete

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  1. Annelies Matthys
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  2. Jo Dehoorne
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Correspondence to Agnieszka Prytuła.

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Matthys, A., Dehoorne, J., Dendooven, A. et al. Favorable course of leptospirosis and hantavirus-induced acute tubulointerstitial nephritis under corticosteroid treatment. Pediatr Nephrol 38, 3853–3857 (2023). https://doi.org/10.1007/s00467-023-05942-w

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