Gulati M S, Miller F, Nord E P
Department of Medicine, State University of New York at Stony Brook, Stony Brook, NY 11794, USA.
Am J Kidney Dis. 1999 Feb;33(2):E9. doi: 10.1016/s0272-6386(99)70330-6.
Idiopathic rapidly progressive glomerulonephritis (RPGN) is a clinicopathologic syndrome in which glomerular damage is accompanied by a rapid and progressive decline in renal function, usually resulting in irreversible renal failure in weeks or months. We report the occurrence of pauci-immune RPGN, more specifically microscopic polyarteritis nodosa (PAN), in a 60-year-old woman 15 months after donor nephrectomy, and 3 months after documentation of intact, residual renal function. The transplanted kidney continues to function well in the recipient, 6 years posttransplantation, and 4.5 years beyond destruction of the donor's contralateral kidney by RPGN. The donor underwent cadaveric renal transplantation after 2 years on dialysis, and at the 3-year mark has intact renal function. These intriguing observations strongly argue that host environmental factors, rather than intrarenal factors, play a major causative role in the pathogenesis of RPGN.
特发性快速进展性肾小球肾炎（RPGN）是一种临床病理综合征，其中肾小球损伤伴随着肾功能迅速进行性下降，通常在数周或数月内导致不可逆的肾衰竭。我们报告了一名60岁女性在供体肾切除术后15个月，以及在记录到残余肾功能完好3个月后发生了少免疫性RPGN，更具体地说是显微镜下结节性多动脉炎（PAN）。移植肾在移植后6年在受者体内继续良好发挥功能，此时供体对侧肾脏已被RPGN破坏超过4.5年。供体在透析2年后接受了尸体肾移植，在3年时肾功能完好。这些有趣的观察结果有力地表明，宿主环境因素而非肾内因素在RPGN的发病机制中起主要致病作用。
