Akira Kamimura

Human parvovirus B19 infection associated with hemolytic uremic syndrome

Abstract A 59-year-old woman developed hemolytic uremic syndrome (HUS) associated with acute human parvovirus B19 (HPVB19) infection. A renal biopsy revealed glomerular mesangiolysis with segmental hypercellularity; mild fibrinogen/fibrin deposits were noted by immunofluorescence study and severe endothelial injury was noted electron microscopically. The histological findings were compatible with HUS. We discuss the relation of HPVB19 to HUS, with special reference to the tropism of the virus for endothelial cells.

Combined membranous nephropathy and crescentic glomerulonephritis with concurrent anti-glomerular basement membrane antibody and myeloperoxidase-specific anti-neutrophil cytoplasmic antibody

We report a case of a 71-year-old man with rapidly progressive nephritic syndrome and dual positivity for anti-glomerular basement membrane antibody and myeloperoxidase-specific anti-neutrophil cytoplasmic antibody. Renal biopsy revealed crescentic, mainly cellular, glomerulonephritis with granulomatous lesions, and advanced membranous changes. Membranous nephropathy had apparently existed for an extended period before the development of crescentic glomerulonephritis. In some studies reporting the simultaneous occurrence of both diseases, membranous nephropathy might be followed by crescentic glomerulonephritis, presumably from a histological point of view. Although we cannot prove a causal relationship between the two diseases, we caution that precise observations, especially histological, are necessary in similar cases.