伴膜增生病变的非典型抗肾小球基底膜肾炎1例报道
A case report of atypical anti-glomerular basement membrane disease with membrane hyperplasia lesions
张昕萍 1王自闯 2陈小永1
作者信息
- 1. 河南中医药大学第二临床医学院肾病科,郑州 450003
- 2. 河南中医药大学第二临床医学院病理科,郑州 450003
- 折叠
摘要
非典型抗肾小球基底膜(glomerular basement membrane,GBM)肾炎罕见,伴有膜增生病变的更为少见,目前对其治疗方案尚未明确.该文报道1例抗GBM抗体阴性,但肾组织活检提示"肾小球膜增生病变伴IgG线样阳性"的非典型抗GBM肾炎病例.该患者以大量蛋白尿、血尿、水肿、肾功能损伤为主要特征,排除继发因素后经肾组织活检诊断为"非典型抗GBM肾炎".给予糖皮质激素联合环磷酰胺治疗后,患者出现肺部感染及急性左心衰竭,转院行规律血液透析治疗.后期发展至终末期肾脏病阶段,继续接受规律血液透析治疗.
Abstract
Atypical anti-glomerular basement membrane(GBM)disease is rare,and the atypical anti-GBM disease with membrane hyperplasia lesion is even rarer.The treatment plan for it is not clear.This article reports a case of atypical anti-GBM disease with a negative anti-GBM antibody test,but renal tissue biopsy showed"glomerular membrane hyperplasia lesions with positive IgG linearity",which provides a reference for clinical diagnosis and treatment.The patient exhibited massive proteinuria,hematuria,edema,and renal impairment.After ruling out secondary factors,the patient was diagnosed with"atypical anti-GBM nephritis"by renal tissue biopsy,and was treated with glucocorticoids combined with cyclophosphamide,after which the patient developed a lung infection and acute left heart failure,and received regular hemodialysis treatment.Then the patient progressed to the stage of end-stage renal disease and continued to receive regular hemodialysis treatment.
关键词
非典型抗肾小球基底膜肾炎/膜增生性病变/肾病综合征Key words
atypical anti-glomerular basement membrane nephritis/membrane proliferative lesion/nephrotic syndrome引用本文复制引用
出版年
2024
NETL
NSTL
万方数据