Mesangio-capillary glomerulonephritis associated with Q-fever endocarditis

A patient with nephrotic syndrome and Q-fever endocarditis (confirmed serologically and ultrastructurally) was found to have mesangio-capillary glomerulonephritis with parietal deposits of C3 and IgM and some IgM in the mesangium. Elution studies showed that IgM antibodies reactive against insoluble Coxiella antigens were present in the kidney. Review of the literature suggests that this type of immune complex nephritis may be associated with Q-fever. Possible reasons for the variability of the nephritis associated with infective endocarditis are discussed.