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Year : 2011  |  Volume : 21  |  Issue : 2  |  Page : 116-119

Postinfectious glomerulonephritis: Is there a role for steroids?

1 Department of Medicine, University of Tennessee College of Medicine, Chattanooga, USA
2 Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee, USA

Correspondence Address:
A S Kapadia
University of Tennessee College of Medicine, Chattanooga, 975 E 3rd Street, P.O. Box 81, Chattanooga, TN 37403
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0971-4065.82141

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The role of steroids in treatment of postinfectious glomerulonephritis (PIGN) has been controversial. The reason for such controversy is the risk of infection relapse associated with steroid therapy. Steroids may have a place in the treatment of resistant cases where renal function does not improve despite aggressive antibiotic therapy as well as in patients with crescentic form of PIGN. We report a case of a 39 year-old Caucasian man who was diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia resulting in acute IgA dominant PIGN that failed to respond to antibiotic treatment alone, but responded significantly to steroids in addition to antibiotics. This anecdotal experience suggests that steroids could be considered in conjunction with antibiotic therapy for the treatment of refractory cases of PIGN or crescentic form of PIGN. More studies with long-term follow-up of patients treated with steroids in addition to antimicrobial agents are required to quantify the risk of infection relapse with steroid therapy.


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Indian Journal of Nephrology
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Online since 20th Sept '07