Infection related membranoproliferative glomerulonephritis secondary to anaplasmosis: A case report

Table 1 Summary of key diagnostic tests

Diagnostic Test	Normal value	Result
ANA	Negative	Negative
Serum DNA double-stranded antibody, IgG	< 30.0 (Negative) IU/mL	< 12.3
Glomerular basement membrane IgG antibody	< 1.0 (Negative) U	< 0.2
Serum myeloperoxidase antibody	< 0.4 (Negative) U	< 0.2
Serum proteinase 3 antibody (PR3)	< 0.4 (Negative) U	< 0.2
Serum complement C3	75-175 mg/dL	42
Serum complement C4	14-40 mg/dL	8
Serum haptoglobin	30-200 mg/dL	17
Serum kappa free light chain	0.3300-1.94 mg/dL	9.28
Serum lambda free light chain	0.5700-2.63 mg/dL	10.9
Kappa/lambda FLC ratio	0.2600-1.65	0.8514
Serum protein electrophoresis	Negative monoclonal proteins	Negative monoclonal proteins
Serum antistrep-O titer	0-530 IU/mL	69
Blood culture	Negative	Negative
Urine culture	Negative	Negative
SARS-CoV-2, PCR, rapid	Undetected	Undetected
EBV DNA, P	Undetected	Undetected
CMV DNA, P	Undetected	Undetected
Anaplasma phagocytophilum, PCR	Undetected	Undetected
Serum Anaplasma phagocytophilum antibody, IgG	< 1:64 titer	1:512
Ehrlichia chaffeensis, PCR	Negative	Negative
Ehrlichia chaffeensis (HME) antibody, IgG	< 1:64	< 1:64
Bartonella antibody panel, IgG and IgM	Negative	Negative
Serum Blastomyces antibody, EIA	Negative	Negative
Histoplasma antibody	Negative	Negative
HIV -1 Ab Screen, P	Negative	Negative
HIV-1 p24 Ag Screen, P	Negative	Negative
HIV Ag/Ab Screen, P	Negative	Negative
HIV-2 Ab Screen, P	Negative	Negative
Serum Mycoplasma antibody, IgM	Negative	Negative
Serum Mycoplasma antibody, IgG	Negative	Positive
Serum total hepatitis B core antibody	Negative	Negative

HIV: Human immunodeficiency virus; ANA: Serum antinuclear antibody; SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2; PCR: Polymerase chain reaction; EBV: Epstein–Barr virus; CMV: Cytomegalovirus; FLC: Free light chains.

Table 2 Laboratory test results

Diagnostic test	Normal value	At presentation	Hospital day 2	Hospital day 6	Hospital day 11	Hospital day 15	On discharge
Hemoglobin, g/dL	11.6-15.0	8.9	8	9.1	9	6.8	7.3
WBC count, ×109/L	3.4-9.6	15.5	16.2	16.8	12.6	8.1	9.2
Platelet count, ×109/L	157-371	118	105	168	157	115	124
Serum Urea Nitrogen, mg/dL	45098	31	36	55	46	66	87
Serum creatinine, mg/dL	0.59-1.04	1.62	1.84	1.02	1.55	2.87	2.95
Serum sodium	135-145 mmol/L	124	123	129	126	127	135
Serum potassium	3.6-5.2 mmol/L	4.5	4.3	3.7	3.8	3.8	4
Serum chloride	98-107 mmol/L	102	100	105	95	95	100
Serum bicarbonate	22-29 mmol/L	11	11	10	20	20	20
eGFR	≥ 60 mL/min/BSA	35	30	62	37	18	17
Anion gap	45122	11	12	12	9	12	15
Serum calcium	8.6-10.0 mg/dL	7.7	7.3	7.8	7.2	7.3	7.6
Serum albumin	3.5-5.0 g/dL	1.6		1.4	1.8

WBC: White blood cell; eGFR: Estimated glomerular filtration rate; BSA: Body surface area.