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Nephrotic “full-house” glomerulonephritis successfully treated with antibiotics alone in secondary syphilis: a case report

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Abstract

A Japanese female in her twenties developed general edema with heavy proteinuria, and was referred to our hospital. She exhibited the common clinical manifestation of idiopathic nephrotic syndrome with massive proteinuria (20.37 g/day), hypoalbuminemia (1.8 g/dL), and hypercholesterolemia (300 mg/dL). Routine admission tests were positive results for both the rapid plasma reagin latex agglutination test for syphilis (RPR) and the Treponema pallidum particle agglutination assay (TPHA). As such, we made her a diagnosis of nephrotic syndrome due to secondary syphilis. Renal biopsy revealed “full-house” nephropathy. Following the commencement of penicillin treatment, she developed skin rash, indicating the Jarisch-Herxheimer reaction (JHR). Her nephrotic syndrome responded rapidly and she achieved complete remission with antibiotic therapy alone after 4 weeks. In light of the increasing incidence of syphilis in Japan, clinicians should consider syphilis as a reversible cause of nephrotic syndrome.

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Data availability

The datasets generated and analyzed during the current st udy are available from the corresponding author on reasonable request.

Abbreviations

MSW:

Men who have sex with women,

WSM:

Women who have sex with men

WSW:

Women who have sex with women

RPR:

Rapid plasma reagin latex agglutination test

TPHA:

Treponema pallidum particle agglutination assay

JHR:

Jarisch–Herxheimer reaction

SLE:

Systemic lupus erythematosus

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Acknowledgements

We thank the neurology staff at Kitano Hospital for cerebrospinal examination. This study was supported in part by a Grant-in-Aid for the Ministry of Health, Labour and Welfare Research on rare and intractable diseases, Program Grant Number 21FC2001 from the Ministry of Health, Labour and Welfare of Japan.

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Authors and Affiliations

  1. Department of Nephrology and Dialysis, Medical Research Institute Kitano Hospital, PIIF Tazuke-Kofukai, 2-4-20 Ohgimachi, Kita-Ku, Osaka, 530-8480, Japan

    Misaki Taniguchi, Tomomi Endo, Mea Asou & Tatsuo Tsukamoto

Authors
  1. Misaki Taniguchi
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  2. Tomomi Endo
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  3. Mea Asou
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  4. Tatsuo Tsukamoto
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Contributions

MT wrote the manuscript with the support of TT. MT, TE and MA treated the patient during hospitalization. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Tomomi Endo.

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The authors have declared that no conflicts of interest exist.

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The ethical committee of Kitano Hospital approved this case report.

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Informed consent was obtained from the patient in this case report.

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Taniguchi, M., Endo, T., Asou, M. et al. Nephrotic “full-house” glomerulonephritis successfully treated with antibiotics alone in secondary syphilis: a case report. CEN Case Rep 13, 86–92 (2024). https://doi.org/10.1007/s13730-023-00803-9

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  • DOI: https://doi.org/10.1007/s13730-023-00803-9

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