Continuous hypergammaglobulinemia and proteinuria after the recovery of the visceral Leishmaniasis: a case report.

Linfeng Zou, Gang Chen, Yangzhong Zhou, Wei Ye, Yubin Wen, Limeng Chen, Xuemei Li

BMC infectious diseases 2021 Jan 28

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Kidney involvement of visceral Leishmaniasis is previously reported, but knowledge is limited. Hypergammaglobulinemia is common in visceral leishmaniasis patients. Whether hypergammaglobulinemia after leishmaniasis depletion can cause kidney injury is not well reported yet. We reported a patient who recovered from visceral Leishmaniasis but showed persistent hypergammaglobulinemia and elevated urinary protein. Kidney biopsy showed glomerular hypertrophy with mild segmental mesangial proliferation without tubulointerstitial involvement in light microscopy. No immune complex deposit was found in the mesangial area by neither immunofluorescent staining nor electronic microscope. Increased lysosomes were observed in proximal tubules by electronic microscope. Valsartan was administered to decrease urinary protein, and no immune-suppressive therapy was added. The urinary protein and serum IgG level gradually dropped, and serum creatinine level remained stable during three- month follow up. Hypergammaglobulinemia is unlikely to cause renal structural or functional damage in the short term. Angiotensin blockade significantly reduced urine protein, with a minor effect on IgG elimination.

Citation

Linfeng Zou, Gang Chen, Yangzhong Zhou, Wei Ye, Yubin Wen, Limeng Chen, Xuemei Li. Continuous hypergammaglobulinemia and proteinuria after the recovery of the visceral Leishmaniasis: a case report. BMC infectious diseases. 2021 Jan 28;21(1):124