[Influenza A: H1N1 post-viral membranoproliferative glomerulonephritis occurring in aggressive systemic mastocytosis: Case report and literature review]

Nephrol Ther. 2022 Apr;18(2):140-143. doi: 10.1016/j.nephro.2021.08.002. Epub 2021 Oct 27.
[Article in French]

Abstract

Systemic mastocytosis is characterised by tissular infiltration and a cytokine storm due to mast cells excessive proliferation and activation. Herein, we report an extraordinary case of AH1N1 influenza post-viral glomerulonephritis occurring in the course of an aggressive systemic mastocytosis with an associated hematological neoplasm. Because of a multisystemic involvement including the liver and lungs, we treated mastocytosis with midostaurin (multiple inhibitor of kinase protein), anti H1/H2 blockers and dexamethasone as first line treatment. One month later and despite vaccination, he developed a severe acute lung injury with respiratory distress due to AH1N1 influenza in association with the nephrotic syndrome. Kidney biopsy disclosed a membranoproliferative glomerulonephritis that was successfully treated with mycophenolate mofetil. Only a few cases of influenza post-viral or post-vaccination glomerulonephritis are documented in the medical literature. This is an exceptional association of uncommon conditions occurring within only a few months in the same patient.

Keywords: Glomerulonephritis; Glomérulonéphrite; Grippe AH1N1; Influenza AH1N1; Mastocytose systémique; Systemic mastocytosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Female
  • Glomerulonephritis* / complications
  • Glomerulonephritis, Membranoproliferative* / complications
  • Glomerulonephritis, Membranoproliferative* / etiology
  • Humans
  • Influenza A Virus, H1N1 Subtype*
  • Influenza, Human* / complications
  • Influenza, Human* / drug therapy
  • Male
  • Mastocytosis, Systemic* / complications
  • Mastocytosis, Systemic* / drug therapy