گلومرولونفريت كرسنتيك (ملاطي ) در بيمار با اندوكارديت عفوني قلب راست

CRESCENTIC GLOMERULONEPIRITIS IN A PATIENT WITH RIGHT- SIDED INFECTIVE ENDOCARDITIS

BACKGROUND AND OBJECTIVE: Infective endocarditis is a disease that causes vegetation on heart valves. Special form of that occurs by intravenous drug abuse and most of patients are young men. Crescentic glomerulonephritis is a rare complication of infective endocarditis that progresses to renal failure during few weeks to few months. CASE: A 40 year old man referred with edema, nausea, vomiting and dyspnea. Due to severe renal failure and hyperkalemia, acute hemodialysis was performed. With regard to fever and heart murmur, an echocardiography was done and a large vegetation on tricuspid valve was appeared. A kidney biopsy was done for determining the cause of renal failure. After a while it was determined that he was an intravenous drug abuser. Pathological report showed many fibrotic crescents and hemodialysis were started. CONCLUSION: With regard to glomerular lesions occurs in 22% of cases with infective endocarditis and since crescentic glomerulonephritis is the most uncommon and has the worst renal prognosis, a high clinical suspicion for renal involvement can help us for a better care of this organ.