HIV-Associated immune complex glomerulonephritis with "lupus-like" features

الملخص EN

Renal structural abnormalities in HIV / AIDS infected patients have been infrequently and incompletely reported in patients from sub-Saharan Africa.

We report an immune complex glomerulonephritis with "lupus-like" features in a ten-year-old HIV+ boy who was evaluated at the University Hospital of Kinshasa.

The light microscopic examination of the renal biopsy displayed a predominantly membranoproliferative glomerulonephritis with prominent focal segmental necrotizing injury, numerous wire-loops, and a spiky membranous nephropathy.

In addition, there was prominent tubular injury, micro cysts filled with periodic acid-Schiff (PAS) Renal structural abnormalities in HIV / AIDS infected patients have been infrequently and incompletely reported in patients from sub-Saharan Africa.

We report an immune complex glomerulonephritis with "lupus-like" features in a ten-year-old HIV+ boy who was evaluated at the University Hospital of Kinshasa.

The light microscopic examination of the renal biopsy displayed a predominantly membranoproliferative glomerulonephritis with prominent focal segmental necrotizing injury, numerous wire-loops, and a spiky membranous nephropathy.

In addition, there was prominent tubular injury, micro cysts filled with periodic acid-Schiff (PAS) positive casts, edema and an inflammatory infiltrate of the interstitial, features of a classic HIV-associated nephropathy (HIVAN).

Electron microscopy revealed large sub endothelial, intra-membranous, sub epithelial and meningeal deposits.

The combination of these findings, while being consistent with lupus nephritis WHO grade IV/V, the tubulointerstitial HIVAN-like changes and the absence of clinical evidence of lupus disease favored an HIV-associated immune complex glomerulonephritis with "lupus-like features".

Positive casts, edema and an inflammatory infiltrate of the interstitial, features of a classic HIV-associated nephropathy (HIVAN).

Electron microscopy revealed large sub endothelial, intra-membranous, sub epithelial and meningeal deposits.

The combination of these findings, while being consistent with lupus nephritis WHO grade IV/V, the tubulointerstitial HIVAN-like changes and the absence of clinical evidence of lupus disease favored an HIV-associated immune complex glomerulonephritis with "lupus-like features."