Clinical Characteristics and Etiologic Analysis of Scabies-Associated Glomerulonephritis
|Zhenglan Gao 1, Hongfei Zhao2, Yunfeng Xia 2*, Hua Gan2and Zheng Xiang3|
|1Department of Nephrology, Chongqing Qijiang Peoples Hospital, Chongqing, PR China|
|2Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China|
|3Department of Nephrology, Second People's Hospital of Xuan Han, Sichuan, PR China|
|Corresponding Author :||Yunfeng X
Department of Nephrology
The First Affiliated Hospital of Chongqing
Medical University, Yuanjiagang
Chongqing, PR China
E-mail: [email protected]
|Received: June 19, 2015 Accepted: July 08, 2015 Published:July 16, 2015|
|Citation:Zhenglan G, Hongfei Z, Hua G, Zheng X, Yunfeng X (2015) Clinical Characteristics and Etiologic Analysis of Scabies-Associated Glomerulonephritis. Intern Med 5: 196. doi:10.4172/2165-8048.1000196|
|Copyright: ©2015 Yunfeng X, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Objective: Scabies-associated glomerulonephritis (SGN) is often seen in certain populations, but little is known about its incidence, clinical characteristics, prognosis and pathogenesis.
Methodology: 376 patients with scabies were enrolled and divided into scabies-alone group (group A) and SGN group (group B) based on the presence or absence of glomerulonephritis. Clinical indicators and various biomarkers, including serum C-reactive protein, complement components C3 and C4, immunoglobulin, TNF-α, IL-6, IL-1β, and IL-18 in the early stage of the disease, were determined before and after treatment. All patients were follow-up in the clinic.
Results: 16 scabies patients developed SGN in this study. The clinical manifestations included glomerular hematuria and/or mild-moderate proteinuria. The manifestations associated with kidney injury in most of these patients completely resolved 2-6 months after scabies was cured. Compared to the patients in group A, the levels of serum CRP, IgG, TNF-α, IL-6, and IL-18 increased significantly and the serum C3 level decreased significantly in the patients in group B. Twelve patients with SGN achieved a clinical cure. Compared to the early stage of the disease, the levels of serum IgG, hs-CRP, TNF-α, IL-6, and IL-18 in these patients decreased significantly after being cured, and the serum C3 level increased significantly.
Conclusions : SGN is generally mild and has a good prognosis. The mechanisms may involve the generation of specific antibodies stimulated by itch mites, triggering of excessive immune and inflammatory responses.