Kohno K, Katayama T, Majima K, Fujisawa M, Iida S, Fukami K, Ueda S, Nishida H, Sata M, Kato S, Morimatsu M, Okuda S
Department of Internal Medicine III, Kurume University School of Medicine, Fukuoka, Japan.
Clin Nephrol. 2000 Jun;53(6):479-82.
A 68-year-old male was admitted for interstitial pneumonia associated with scleroderma. High-dose methylprednisolone was administered for treatment of the pneumonitis. Two weeks later, anemia, thrombocytopenia and progressive increase in BUN, creatinine and LDH were observed. Although the blood pressure remained normotensive, renal biopsy showed thrombosis of the polar arterioles and glomerular capillaries. The affected interlobular artery included concentric intimal thickening and thrombosis in the lumen. Our findings suggested that the antecedent use of high-dose corticosteroids is involved in precipitating normotensive renal crisis. Corticosteroids should be used in low doses and with great caution in scleroderma patients.
一名68岁男性因硬皮病相关的间质性肺炎入院。给予大剂量甲基强的松龙治疗肺炎。两周后，出现贫血、血小板减少以及血尿素氮、肌酐和乳酸脱氢酶进行性升高。尽管血压仍正常，但肾活检显示极动脉和肾小球毛细血管血栓形成。受累的小叶间动脉可见同心性内膜增厚及管腔内血栓形成。我们的研究结果提示，先前使用大剂量皮质类固醇与引发血压正常的肾危象有关。硬皮病患者应低剂量且谨慎使用皮质类固醇。
