Membranoproliferative Glomerulonephritis Due to Hepatic Hydatid Disease

TL;DR

A 16-year-old boy with hydatid disease developed kidney damage, but recovered after surgery and treatment, showing the link between this parasite and kidney issues.

Contribution

Reports a rare case linking hepatic hydatid disease to membranoproliferative glomerulonephritis and successful treatment outcomes.

Findings

Renal biopsy showed immune complex-mediated MPGN linked to classical complement pathway activation.

Post-surgery and albendazole treatment, proteinuria and renal function normalized within a month.

Hydatid disease should be considered in nephrotic syndrome cases in endemic regions.

Abstract

Hydatid disease is a parasitic infection primarily involving the liver and is prevalent in Mediterranean and other endemic regions. Although commonly hepatic, its association with glomerular injury is extremely rare. We report the case of a 16-year-old male with a history of chronic cough and exposure to dogs who presented with generalized edema, macroscopic hematuria, and renal impairment. Laboratory evaluation confirmed nephrotic-range proteinuria, hypoalbuminemia, and impaired renal function. Renal biopsy revealed immune complex-mediated membranoproliferative glomerulonephritis (MPGN) with activation of the classical complement pathway. Imaging identified hepatic cystic lesions, and hydatid serology was positive. The patient underwent surgical excision of the cyst followed by albendazole therapy. Postoperatively, proteinuria decreased to 1.78 g/24 h by day 7 and resolved completely by day 30, with normalization of renal function and serum albumin levels. This case highlights the importance of considering hydatid disease in the differential diagnosis of unexplained nephrotic syndrome in endemic regions, as early recognition and appropriate management can lead to full recovery.

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