Infection-related glomerulonephritis presenting as acute kidney injury and nephrotic syndrome caused by human adenovirus III successfully treated with cyclosporine and methylprednisolone pulse therapy

Infection-related glomerulonephritis (IRGN) caused by adenovirus is a rare condition, and there are no reports of kidney biopsy. Herein, we report a 2-year-old boy with IRGN caused by human adenovirus Ⅲ who required dialysis due to acute kidney injury and subsequently presented with persistent nephrotic syndrome. Kidney biopsy showed diffuse endocapillary proliferation with 30% cellular crescents. Histological staining showed positivity for nephritis-associated plasmin receptor (NAPlr) and plasmin activity in the glomeruli. The patient received cyclosporine and methylprednisolone pulse therapy once a month and 1 mg/kg of oral prednisolone every other day. Thereafter, he achieved complete remission. According to our case, NAPlr staining could be positive in IRGN caused by viral infections. The combination of cyclosporine and methylprednisolone pulse therapy might be effective for the severe type of IRGN.