Syphilis and parvovirus B19 co-infection imitating a lupus nephropathy: A case report.

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State: Public
Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_96A81A1445A0
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Syphilis and parvovirus B19 co-infection imitating a lupus nephropathy: A case report.
Journal
Medicine
Author(s)
Jaunin E., Kissling S., Rotman S., Waeber G., Halfon M.
ISSN
1536-5964 (Electronic)
ISSN-L
0025-7974
Publication state
Published
Issued date
09/2019
Peer-reviewed
Oui
Volume
98
Number
36
Pages
e17040
Language
english
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Abstract
Syphilis can share clinical features with autoimmune diseases, such as cutaneous Lupus or rheumatoid arthritis. Moreover, secondary syphilis can have visceral involvement, thus affecting the kidney. Syphilitic nephropathy causes nephrotic syndrome with a classic membranous pattern. We present a unique presentation of a co-infection by syphilis and parvovirus B19 sharing all the biological and histological features of proliferative lupus nephritis (LN).
We present a case of a 71-year-old Caucasian male returning from a trip to Asia presenting with nephrotic syndrome with antinuclear antibodies (ANA) positivity.
Because of nephrotic syndrome a kidney biopsy was performed. It demonstrated a membranous nephropathy with extracapillary proliferation and a full house pattern (presence of IgA, IgG, IgM and C1Q deposits) on immunofluorescence (IF), highly suggestive of LN class III and V. However, several atypical clinical features notably the age, sex of the patient and the history of travel prompt us to search for another cause of nephropathy.
A serology was positive for syphilis and a PCR in the renal biopsy was also positive for parvovirus B19. Thus, a co-infection by syphilis and parvovirus B19 was funded to be the cause of the renal lesions.
The proteinuria improved; a course of antibiotic was administrated because of neurologic syphilitic involvement (presence of headache with positive syphilis serology in the CSF).
A co-infection by syphilis and parvovirus B19 can share all the biological and histological features of proliferative LN and must be recognized as a cause of pseudo-lupus nephritis.
Keywords
Aged, Coinfection, Diagnosis, Differential, Erythema Infectiosum/complications, Erythema Infectiosum/diagnosis, Humans, Lupus Nephritis/diagnosis, Male, Syphilis/complications, Syphilis/diagnosis
Pubmed
Web of science
Open Access
Yes
Create date
13/09/2019 11:12
Last modification date
25/01/2020 7:09
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