血浆置换成功救治感染性心内膜炎相关急性肾衰竭1例
A case of successful plasma exchange in the treatment of acute renal failure related to infective endocarditis
孙颖 1王海涛 1方芳 2王松岚 1刘昕 1毛永辉1
作者信息
- 1. 北京医院肾内科 国家老年医学中心 中国医学科学院老年医学研究院,北京 100730
- 2. 北京医院病理科 国家老年医学中心 中国医学科学院老年医学研究院,北京 100730
- 折叠
摘要
患者男性,65岁,因纳差消瘦、肉眼血尿、皮肤紫癜和急性肾衰竭入院,入院前3个月曾于外院接受心血管介入检查.住院期间多次血培养示格氏链球菌阳性,血补体下降和类风湿因子升高,超声心动图提示二尖瓣赘生物(4 mm),肾活检提示毛细血管内增生性肾小球肾炎,临床诊断为感染性心内膜炎相关肾小球肾炎.给予有效抗生素联合血浆置换治疗,临床症状和急性肾衰竭显著改善.该病例提示血浆置换对感染性心内膜炎所致的免疫复合物介导的肾小球肾炎的疗效可靠且安全,为治疗此类病例提供了新的诊疗思路.
Abstract
A 65-year-old male was admitted because of anorexia,gross hematuria,skin purpura and acute renal insufficiency.Cardiovascular interventional examination was performed in other hospital 3 months before admission.During hospitalization,multiple blood cultures suggested positive Streptococcus gordonii,decreased blood complement and increased rheumatoid factor.Echocardiography revealed mitral valve vegetations(4 mm),and renal biopsy revealed endocapillary proliferative glomerulonephritis,diagnosed as infective endocarditis-associated glomerulonephritis.The combination of effective antibiotics and plasma exchange therapy significantly improved clinical symptoms and acute renal failure.The case suggests that plasma exchange is effective and safe in the treatment of immune complex-mediated glomerulonephritis caused by infective endocarditis,providing a new option for the treatment of such diseases.
关键词
心内膜炎,细菌性/急性肾损伤/血浆置换Key words
Endocarditis,bacterial/Acute kidney injury/Plasma exchange引用本文复制引用
基金项目
中央高水平医院临床科研业务项目(BJ-2022-105)
出版年
2024
NETL
NSTL
万方数据