Cabezuelo J B, Enríquez R, Andrada E, Amorós F, Sirvent A E, Reyes A
Sección de Nefrología, Hospital General Universitario de Elche, Alicante.
Nefrologia. 2000 Jul-Aug;20(4):379-82.
We describe a 36 year old man who was admitted to the hospital with dyspnea, edema of the lower limbs, arterial hypertension and oliguric renal failure. He had microhematuria and nephrotic range proteinuria, immunological tests were normal or negative. Renal biopsy revealed global (55%) or segmental glomeruloesclerosis, remaining glomeruli showed extracapillary proliferation (25%). Immunofluorescence study disclosed IgA mesangial deposits. He was also diagnosed as having liver cirrhosis with positive serology against hepatitis C virus. He was treated with dialysis, antihypertensive drugs and steroids with improvement of the renal function. However, ten months later maintenance hemodialysis became necessary. We emphasize two points: first IgA glomerulonephritis is rarely associated with hepatitis C infection, and second crescentic IgA nephropathy has been infrequently reported in liver cirrhosis.
我们描述了一名36岁男性,他因呼吸困难、下肢水肿、动脉高血压和少尿性肾衰竭入院。他有镜下血尿和肾病范围蛋白尿,免疫检查正常或呈阴性。肾活检显示全球(55%)或节段性肾小球硬化,其余肾小球显示毛细血管外增生(25%)。免疫荧光研究发现IgA系膜沉积。他还被诊断为丙型肝炎病毒血清学阳性的肝硬化。他接受了透析、抗高血压药物和类固醇治疗,肾功能有所改善。然而,十个月后需要维持性血液透析。我们强调两点:第一,IgA肾小球肾炎很少与丙型肝炎感染相关;第二,肝硬化中新月体性IgA肾病鲜有报道。