Crescentic glomerulonephritis associated with miliary tuberculosis

We report a 70-year-old man who presented with cervical lymphadenopathy, hypercalcemia, and acute renal failure. Lymph node biopsy revealed caseating granulomas. Renal biopsy showed immune complex-mediated diffuse proliferative glomerulonephritis with crescentic formation. Ultrastructural features of the glomerular disease were compatible with the description in infectious glomerulonephritis. Disseminated tuberculosis was diagnosed when sputum, urine, and bone marrow cultures confirmed the presence of Mycobacterium tuberculosis. Successful treatment with antituberculous agents accompanied by recovery of renal function. As far as we know, the association of tuberculosis with glomerulonephritis appears to be exceedingly rare. In addition to describing this case, we also review cases of tuberculosis-associated glomerulonephritis retrieved from the literature.