Membranoproliferative Glomerulonephritis in Patients with Chronic Venous Catheters: A Case Report and Literature Review

Table 1

Clinical manifestations of reported cases and current case.

References	Medical history	Initial presentation	Baseline creatinine (mg/dL)	Presenting creatinine (mg/dL)	Urinalysis	Complements (mg/dL)	Renal Biopsy	Blood cultures	Number of catheter changes
Yared et al. [7]	66-year-old male with mesenteric ischemia and bowel resection with parenteral nutrition for hyperalimentation	Worsening kidney function and new skin rash	1.5	3.2	>25 RBC/HPF, proteinuria, 4–10 granular casts	“Normal” complements (values not reported)	MPGN	S. epidermidis and; C. jeikeium	6
Yared et al. [7]	45-year-old female TAH/BSO complicated by ischemic bowel requiring resection, required parenteral nutrition for hyperalimentation	Worsening kidney function, new skin rash, and severe anemia	1.8	7.7	Proteinuria and hematuria with RBC and mixed-cell casts	Initially normal complements, then C3 and C4 levels slightly depressed	MPGN	Unknown	5
Ohara et al. [6]	13-year-old male midgut volvulus and resection of necrotic ileum, required parenteral nutrition for hyperalimentation	Hematuria and proteinuria on routine urinary screening	Unknown	0.6	Many RBCs, 10–15 WBC, 1-2 granular casts/HPF	C3 30 (low), C4 8 (low), CH50 < 10 (low)	MPGN	S. epidermidis	7
Current case report	23-year-old male multiple gunshot wounds to abdomen at age 17, required parenteral nutrition for hyperalimentation	First episode; July 1996: proteinuria, hematuria, and renal insufficiency on routine testing	Unknown	1.9	2+ blood, >100 RBC, no cellular casts	C3 69 (low), C4 19 (low-normal), CH50 < 28 (low)	MPGN	S. epidermidis	Unknown
		Second episode; February 2010 at age 37: fevers, anasarca, and renal insufficiency	1.3–1.5	2.2	Protein 300 mg/dL, large blood, WBC 196, RBC 224, +hyaline, granular, and cellular casts/HPF	C3 71 (low), C4 23 (low-normal), CH50 < 13 (low)	MPGN (biopsy done June 2010)	S. epidermidis	>2
		Third episode; July 2010: anasarca and fatigue	1.7–2.0	3.3	Protein 100 mg/dL, large blood, WBC 215, RBC 252, 42 hyaline casts/HPF	C3 45 (low), C4 18 (low-normal), CH50 < 13 (low)	No biopsy*	S. epidermidis	>2

Abbreviations: TAH/BSO: total abdominal hysterectomy and bilateral salpingooopherectomies; S. epidermidis: Staphylococcus epidermidis; C. jeikeium: Clostridium jeikeium; RBC: red blood cells; WBC: white blood cells; HPF: high power field.
*Presumptive diagnosis of recurrent MPGN based on previous biopsy findings, clinical course, and response to appropriate therapy.