ABSTRACT
Immunoglobulin A (IgA) nephropathy is the commonest type of glomerular nephritis worldwide and is one of the leading causes of chronic kidney disease. Erythrocytosis is known to be associated with IgA nephropathy and other renal manifestations. We report a case of a 35-year-old male with grade 3 hypertensive retinopathy, erythrocytosis, and heavy proteinuria with an impaired renal function who was diagnosed as a case of erythrocytosis with IgA nephropathy and secondary focal segmental glomerulosclerosis. An extensive evaluation and prompt interventions significantly improved the outcome in this patient.
ABSTRACT
Scrub typhus is an important etiological cause for acute undifferentiated febrile illness in the Asia-Pacific region, including Sri Lanka. It is a mite-borne disease caused by Orientia tsutsugamushi. Hemophagocytic lymphohistiocytosis (HLH) is a rapidly progressive and potentially life-threatening hyperinflammatory syndrome rarely associated with scrub typhus. We herein describe a rare case of scrub typhus complicated by hemophagocytic lymphohistiocytosis in a 40-year-old previously healthy woman who presented with a history of an acute febrile illness. Following the observation of acute deterioration of hematological parameters despite the nature of the febrile illness, the rare association of hemophagocytic lymphohistiocytosis was considered, and this disease association was confirmed by fulfilling six out of eight of the diagnostic criteria of haemophagocytic lymphohistiocytosis. The patient made an uneventful recovery following treatment for the precipitating illness and with supportive care.
