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Pediatric Nephrology

, Volume 21, Issue 5, pp 740–742 | Cite as

Cytomegalovirus-related congenital nephrotic syndrome with diffuse mesangial sclerosis

  • Nesrin Besbas
  • Umut Selda BayrakciEmail author
  • Gulsev Kale
  • Ali Bulent Cengiz
  • Zuhal Akcoren
  • Devrim Akinci
  • Ilke Kilic
  • Aysin Bakkaloglu
Brief Report

Abstract

This case report describes congenital nephrotic syndrome in a 2-month-old girl associated with cytomegalovirus infection. Histological examination on renal biopsy showed diffuse mesangial sclerosis and cytomegalic inclusion bodies in the tubular cells and in some glomeruli. Cytomegalovirus (CMV) polymerase chain reaction (PCR) titer in serum was high. Remission of pulmonary and renal symptoms was achieved with ganciclovir in 3 weeks. No recurrence of proteinuria was observed during the follow-up period of 14 months. These finding suggested a causal relationship between congenital nephrotic syndrome and cytomegalovirus infection.

Keywords

Early onset nephrotic syndrome Cytomegalovirus Diffuse mesangial sclerosis Treatment Ganciclovir 

References

  1. 1.
    Holmberg C, Jalanko H, Tryggvason K, Rapola J (1999) Congenital nephrotic syndrome. In: Barratt TM, Avner ED, Harmon WE (eds) Pediatric nephrology, 4th edn. Lippincott Williams and Wilkins, Philadelphia, pp 765–777Google Scholar
  2. 2.
    Giani M, Efedonti A, Damiani B, Marra G, Colombo D, Banfi G, Rivolta E, Strom EH, Mihatsch M (1996) Nephrotic syndrome in a mother and her infant: relationship with cytomegalovirus infection. Pediatr Nephrol 10:73–75CrossRefGoogle Scholar
  3. 3.
    Batisky DL, Roy S, Gaber LW (1993) Congenital nephrosis and neonatal cytomegalovirus infection: a clinical association. Pediatr Nephrol 7:741–743CrossRefGoogle Scholar
  4. 4.
    Evans DGR, Lyon AJ (1991) Fatal congenital cytomegalovirus infection acquired by an intra-uterine transfusion. Eur J Pediatr 150:780–781CrossRefGoogle Scholar
  5. 5.
    Frishberg Y, Rinat C, Feinstein S, Becker-Cohen R, Megged O, Schlesinger Y (2003) Mutated podocin manifesting as CMV-associated congenital nephrotic syndrome. Pediatr Nephrol 18:273–275PubMedGoogle Scholar
  6. 6.
    Ahlfors K, Ivarsson S, Harris S, Svanberg L, Holmqvist R, Lernmark B, Theander G (1984) Congenital cytomegalovirus infection and disease in Sweden and the relative importance of primary and secondary maternal infections. Scand J Infect Dis 16:129–137CrossRefGoogle Scholar
  7. 7.
    Andersen HK, Brostrom K, Hanssen B, Leerhoy J, Pedersen M, Osterballe O, Felsager U, Mogensen S (1979) A prospective study on the incidence and significance of congenital cytomegalovirus infection. Acta Pediatr Scand 68:329–336CrossRefGoogle Scholar
  8. 8.
    Barbi M, Binda S, Primache V, Clerici D (1998) Congenital cytomegalovirus infection in a Northen Italian region. Eur J Epidemiol 14:791–796CrossRefGoogle Scholar
  9. 9.
    Gandhi MK, Khanna R (2004) Human cytomegalovirus: clinical aspects, immune regulation, and emerging treatments. Lancet Infect Dis 4:725–738CrossRefGoogle Scholar
  10. 10.
    Coyle PV, Wyatt DE, Ong GM, Maxvell AP, McCaughey J, O’Neill HJ (2002) A nested primer set targeting cytomegalovirus glycoprotein B gene. J Clin Virol 25:95–96CrossRefGoogle Scholar
  11. 11.
    Sibley RK, Striegel J (1994) Nephrotic syndrome in the first year of life. In: Tischer CC, Brenner BM (eds) Renal pathology: with clinical and functional correlations, 2nd edn. Lippincott, Philadelphia, pp 1291–1311Google Scholar
  12. 12.
    McTaggart SJ, Algar E, Chow CW, Powell HR, Jones CL (2001) Clinical spectrum of Denys–Drash and Frasier syndrome. Pediatr Nephrol 16:335–339CrossRefGoogle Scholar
  13. 13.
    Kucharczuk K, de Giorgi AM, Golden J, Zacharowicz L, van den Heuvel LP, Kaplan BS (2000) Additional findings in Galloway–Movat syndrome. Pediatr Nephrol 14:406–409CrossRefGoogle Scholar

Copyright information

© IPNA 2006

Authors and Affiliations

  • Nesrin Besbas
    • 1
  • Umut Selda Bayrakci
    • 1
    Email author
  • Gulsev Kale
    • 2
  • Ali Bulent Cengiz
    • 3
  • Zuhal Akcoren
    • 2
  • Devrim Akinci
    • 4
  • Ilke Kilic
    • 5
  • Aysin Bakkaloglu
    • 1
  1. 1.Department of Pediatric Nephrology, Faculty of MedicineHacettepe UniversityAnkaraTurkey
  2. 2.Department of Pediatric Pathology, Faculty of MedicineHacettepe UniversityAnkaraTurkey
  3. 3.Department of Pediatric Infectious Diseases, Faculty of MedicineHacettepe UniversityAnkaraTurkey
  4. 4.Department of Radiology, Faculty of MedicineHacettepe UniversityAnkaraTurkey
  5. 5.Department of Pediatrics, Faculty of MedicineHacettepe UniversityAnkaraTurkey

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