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Acute kidney injury in an adult patient with IgA nephropathy and chronic replicative Epstein–Barr virus infection

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Abstract

Most of the adult population are infected with Epstein–Barr virus (EBV), but as EBV replication is usually under immune system control, the majority of individuals remain asymptomatic. On the other hand, some individuals continuously retain a high EBV antibody titer and a high EBV DNA load in their blood, suggesting a defect of EBV replication control. To date, only a limited number of reports have addressed the relationship between this chronic form of EBV infection and renal involvement. Here, we describe an 80-year-old woman who developed acute kidney injury shortly after an episode of mosquito bites, accompanied by a severe skin rash, which raised a suspicion of chronic EBV infection. She was subsequently diagnosed as having chronic replicative EBV infection. Renal biopsy revealed a diagnosis of IgA nephropathy with crescent formation. Although the relationship between IgA nephropathy and EBV infection has been discussed, no substantial understanding has yet emerged. The patient’s characteristic clinical course suggested that the renal failure may have been partly attributable to chronic EBV infection. This case suggests that physicians may need to consider the possibility that chronic EBV infection may affect the clinical course of IgA nephropathy, or exacerbate the disease.

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Abbreviations

EBV:

Epstein–Barr virus

CAEBV:

Chronic active Epstein–Barr virus

HMB:

Hypersensitivity to mosquito bite

Ig:

Immunoglobulin

ANCA:

Antineutrophil cytoplasmic antibody

VCA:

Viral capsid antigen

NA:

Nuclear antigen

EBER-1:

EBV encoded RNA 1

CD:

Cluster of differentiation

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Authors and Affiliations

  1. Department of Internal Medicine, Nagaoka Red Cross Hospital, 2-297-1 Sensyu, Nagaoka, Niigata, 940-2085, Japan

    Yuya Sato, Kaito Furuyama, Takeshi Suzuki, Tomoyuki Tanaka, Akira Iguchi & Hajime Yamazaki

  2. Department of Dermatology, Nagaoka Red Cross Hospital, 2-297-1 Sensyu, Nagaoka, Niigata, 940-2085, Japan

    Ami Sato

  3. Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan

    Kazuhiro Yoshita, Yumi Ito, Naofumi Imai & Ichiei Narita

Authors
  1. Yuya Sato
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  2. Kaito Furuyama
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  3. Takeshi Suzuki
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  4. Tomoyuki Tanaka
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  5. Ami Sato
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  6. Akira Iguchi
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  7. Kazuhiro Yoshita
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  8. Yumi Ito
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  9. Naofumi Imai
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  10. Hajime Yamazaki
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  11. Ichiei Narita
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Correspondence to Yuya Sato.

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Sato, Y., Furuyama, K., Suzuki, T. et al. Acute kidney injury in an adult patient with IgA nephropathy and chronic replicative Epstein–Barr virus infection. CEN Case Rep 8, 285–291 (2019). https://doi.org/10.1007/s13730-019-00409-0

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  • DOI: https://doi.org/10.1007/s13730-019-00409-0

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