Skip to main content

Advertisement

Log in

Microscopic polyangiitis triggered by recurrent methicillin-resistant Staphylococcus aureus bacteremia

  • Nephrology - Case Report
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Most of the purported links between microbial agents and primary small-vessel anti-neutrophilic antibody-positive (ANCA) vasculitides remain speculative. There is strong circumstantial evidence for the role of Staphylococcus aureus in the development of Wegener’s granulomatosis, but its role in other ANCA-positive vasculitis syndromes is less clear. We describe a patient who developed a non-granulomatous, necrotizing small-vessel vasculitis with a positive anti-neutrophil cytoplasmic antibody of a perinuclear type (p-ANCA), along with anti-myeloperoxidase antibodies after recurrent episodes of methicillin-resistant Staphylococcus aureus bacteremia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

References

  1. Stegeman CA, Cohen Tervaert JW, Sluiter WJ, Manson WL, de Jong PE, Kallenberg CGM (1994) Association of chronic nasal carriage of Staphylococcus aureus and higher relapse rates in Wegener granulomatosis. Ann Intern Med 120(1):12–17

    CAS  PubMed  Google Scholar 

  2. DeRemee RA, McDonald TJ, Weiland LH (1985) Wegener’s granulomatosis: observations on treatment with antimicrobial agents. Mayo Clin Proc 60:27–32

    CAS  PubMed  Google Scholar 

  3. Hellmich B, Ehren M, Lindstaedt M, Meyer M, Pfohl M (2001) Schatz H: anti-MPO-ANCA-positive microscopic polyangiitis following subacute bacterial endocarditis. Clin Rheumatol 20:441–443

    Article  CAS  PubMed  Google Scholar 

  4. Miranda-Filloy JA, Veiga JA, Juarez Y, Gonzalez-Juanatey C, Gonzalez-Gay MA, Garcia-Porrua C (2006) Microscopic polyangiitis following recurrent Staphylococcus aureus bacteremia and infectious endocarditis. Clin Exp Rheumatol 24(6):705–706

    CAS  PubMed  Google Scholar 

  5. Davson J, Ball J, Platt R (1948) The kidney in periarteritis nodosa. Q J Med 17:175–202

    CAS  PubMed  Google Scholar 

  6. Jennette JC, Falk RJ, Andrassy K et al (1994) Nomenclature of systemic vasculitides: proposal of an international consensus conference. Arthritis Rheum 37:187–192

    Article  CAS  PubMed  Google Scholar 

  7. Kelley WN (1997) Vasculitis and related disorders. In: Textbook of rheumatology, 5th edn. Saunders, Philadelphia, pp 1079–1101

  8. Jennette JC, Falk RJ (1997) Small-vessel vasculitis. N Engl J Med 337(21):1512–1523

    Article  CAS  PubMed  Google Scholar 

  9. Savage CO, Harper L, Adu D (1997) Primary systemic vasculitis. Lancet 349(9051):553–558

    Article  CAS  PubMed  Google Scholar 

  10. Kamesh L, Harper L, Savage CO (2002) ANCA-positive vasculitis. J Am Soc Nephrol 13(7):1953–1960

    Article  PubMed  Google Scholar 

  11. van Wijngaarden RA, van Rijn L, Hagen EC et al (2008) Hypotheses on the etiology of antineutrophil cytoplasmic autoantibody associated vasculitis: the cause is hidden, but the result is known. Clin J Am Soc Nephrol 3(1):237–252

    Article  Google Scholar 

  12. Zeledon JI, McKelvey RL, Servilla KS et al (2008) Glomerulonephritis causing acute renal failure during the course of bacterial infections. Histological varieties, potential pathogenetic pathways and treatment. Int Urol Nephrol 40(2):461–470

    Article  CAS  PubMed  Google Scholar 

  13. Kon Y, Bohgaki M, Notoya A et al (2006) Microscopic polyangiitis triggered by fungal infection. Hokkaido Igaku Zasshi 81(1):5–8

    PubMed  Google Scholar 

  14. Cohen Tervaert JA, Popa RA, Bos NA (1999) The role of superantigens in vasculitis. Curr Opin Rheumatol 11:24–33

    Article  Google Scholar 

  15. George J, Levy Y, Kallenberg CG (1997) Shoenfeld Y: infections and Wegener’s granulomatosis: a cause and effect relationship? QJM 90:367–373

    Article  CAS  PubMed  Google Scholar 

  16. Pendergraft WF III, Preston GA, Shah RR et al (2004) Autoimmunity is triggered by cPR-3(105–201), a protein complementary to human autoantigen proteinase-3. Nat Med 10:72–79

    Article  CAS  PubMed  Google Scholar 

  17. Bautz DJ, Preston GA, Lionaki S et al (2008) Antibodies with dual reactivity to plasminogen and complementary PR3 in PR3-ANCA vasculitis. J Am Soc Nephrol 19(12):2421–2429

    Article  CAS  PubMed  Google Scholar 

  18. Yang J, Bautz DJ, Lionaki S et al (2008) ANCA patients have T cells responsive to complementary PR-3 antigen. Kidney Int 74(9):1159–1169

    Article  CAS  PubMed  Google Scholar 

  19. Caputo A, Fahey D, Lloyd C, Vozab R, McCairns E, Rowe PB (1988) Structure and differential mechanisms of regulation of expression of a serine esterase gene in activated human T lymphocytes. J Biol Chem 263:6363–6369

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rahil Kasmani.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kasmani, R., Okoli, K., Naraharisetty, K. et al. Microscopic polyangiitis triggered by recurrent methicillin-resistant Staphylococcus aureus bacteremia. Int Urol Nephrol 42, 821–824 (2010). https://doi.org/10.1007/s11255-009-9652-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-009-9652-8

Keywords

Navigation