Case Report: Lupus Nephritis, or a Mimic?

In Sum

It’s important to recognize the above etiologies of membranous nephropathy because the correct diagnosis has treatment implications. The nephrotic syndrome associated with parvovirus B19 infection may improve spontaneously and that with syphilis improves with penicillin.^3,5-7 A similar case of co-infection with both parvovirus B19 and syphilis improved with antibiotic treatment for syphilis.¹

Matthew J. Mandell, DO, FACP, is a board-certified internist and rheumatologist, and clinical assistant professor of internal medicine at Northwestern University, Chicago. He completed his rheumatology fellowship training at the University of Iowa Hospitals & Clinics.

Yishui Chen, MD, is a second-year neurology resident at the University of Iowa Hospitals & Clinics.

Prerna Rastogi, MD, PhD, is clinical associate professor of pathology and medical director of electron microscopy and outlying urgent care and hematology/ oncology laboratories at the University of Iowa Hospitals & Clinics.

Rebecca Tuetken, MD, PhD, is a clinical professor of internal medicine (immunology), medical director of the Medical Specialty Clinic, and director of the rheumatology fellowship program at the University of Iowa Hospitals & Clinics.

References

   
1. Jaunin E, Kissling S, Rotman S, et al. Syphilis and parvovirus B19 co-infection imitating a lupus nephropathy: A case report. Medicine (Baltimore). 2019 Sep;98(36):e17040.
2. Young MF, Sanowski RA, Manne RA. Syphilitic hepatitis. J Clin Gastroenterol. 1992 Sep;15(2):174–176.
3. Scaperotti MM, Kwon D, Kallakury BV, Steen V. Not all that is ‘full house’ is systemic lupus erythematosus: A case of membranous nephropathy due to syphilis infection. BMJ Case Rep. 2021 Aug 19;14(8):e244466.
4. Hook EW 3rd. Syphilis. Lancet. 2017 Apr 15;389(10078):1550–1557. Erratum in: Lancet. 2019 Mar 9;393(10175):986.
5. Georges E, Rihova Z, Cmejla R, et al. Parvovirus B19 induced lupus-like syndrome with nephritis. Acta Clin Belg. 2016 Dec;71(6):423–425.
6. Hannawi B, Raghavan R. Syphilis and kidney disease: A case report and review of literature. Nephrology Research & Reviews. 2012;4(2):45–47.
7. Ohtomo Y, Kawamura R, Kaneko K, et al. Nephrotic syndrome associated with human parvovirus B19 infection. Pediatr Nephrol. 2003 Mar;18(3):280–282.