From Uganda to Italy: a case of nephrotic syndrome secondary to Plasmodium infection, Quartan malarial nephropathy and kidney failure

Abstract

Malaria (M), the first parasitic infection, is sometimes associated withnephrotic syndrome (NS) in tropical areas. Kidney involvement during quartanmalaria is represented by immune-complex mediated glomerulonephritis(GN). Generally, NS develops several weeks after onset of quartan fever andits clinical course proceeds slowly to end-stage kidney disease (ESKD) evenafter eradication of the infection. We describe a case of Plasmodium malariaeassociated nephrotic syndrome and chronic proliferative glomerulopathyin a boy from Uganda. Renal biopsy revealed chronic proliferative GN withcapillary wall thickening producing a double contour, segmental sclerosis andtubular atrophy. Blood Giemsa smear contained rare ring-form trophozoitesand gametocytes of Plasmodium spp. This case highlights the importance ofobtaining remote travel histories from immigrants presenting with nephroticsyndrome especially due to the current immigration crisis in Europe. Malariahas low prevalence or less known in our continent and requires more medicalattention by European doctors.