Mycoplasma pneumoniae infection is a rare cause of acute nephritis. Six children (2 girls) aged 5–10 years, admitted for nephritis, had serological
tests showing recent
Mycoplasma pneumoniae infection. The diagnosis of
Mycoplasma pneumoniae infection was based on the presence of serum IgM, detected either by immunofluorescence (IF) (
n=1) or enzyme-linked immunosorbent assay (
n=5). Four children had a renal biospy, with analysis of parenchymal
Mycoplasma pneumoniae components by indirect IF and polymerase chain reaction. Extrarenal symptoms were: respiratory (
n=3), ear, nose, and throat (
n=2), gastrointestinal (
n=3), hepatic (
n=1), neurological (
n=1), articular (
n=1), and hematological (
n=3). The patients presented with acute nephritis (1 had a nephrotic syndrome) or with acute renal failure and proteinuria.
Pathological findings included type 1 membranoproliferative glomerulonephritis (MPGN,
n=1), proliferative endocapillary glomerulonephritis (
n=2), and minimal change disease (
n=1). The patient with type 1 MPGN progressed rapidly towards end-stage renal failure because of a congenital solitary kidney.
Among the patients with endocapillary glomerulonephritis, 1 relapsed 6 months later and remained proteinuric, while the other
recovered, as did the child with minimal change disease. The search for
Mycoplasma pneumoniae antigens and nucleic acids in renal tissue was negative. However, the absence of the microorganism in the kidney is a common
feature of post-streptococcal glomerulonephritis. We conclude that
Mycoplasma pneumoniae is a rare yet potential cause of acute glomerulonephritis.
Received: 13 September 1996 / Revised: 16 June 1998 / Accepted: 18 June 1998
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