Shimizu T, Tanabe K, Tokumoto T, Shimmura H, Koga S, Ishikawa N, Oshima T, Toma H, Yamaguchi Y
Department of Urology, Kidney Center, Tokyo Women's Medical University, Japan.
Clin Transplant. 2001;15 Suppl 5:11-5. doi: 10.1034/j.1399-0012.2001.0150s5011.x.
A 46-yr-old Japanese male who underwent a second cadaveric kidney transplantation on 31 October 1996 after suffering Type II diabetic mellitus for 25 yr was admitted to our institute on 23 January 1999, because of colicky abdominal pain and abdominal discomfort. Elevated levels of serum creatinine, severe proteinuria and microscopic haematuria were observed. The allograft biopsy specimen disclosed crescentic glomerulonephritis. Immunofluorescence showed granular deposits of mainly IgA and C3 along glomerular capillary walls and mesangial areas. Electron microscopy showed extensive subepithelial and mesangial electron dense deposits. Rapid and irreversible worsening of graft function led to resumption of haemodialysis on 31 May 1999. We speculated that this case was an atypical form of de novo Henoch-Schönlein purpura nephritis (HSPN) in transplanted kidney because of the histopathological findings of the allograft biopsy and clinical symptoms.
一名46岁的日本男性，患II型糖尿病25年后，于1996年10月31日接受了第二次尸体肾移植。1999年1月23日因绞痛性腹痛和腹部不适入住我院。观察到血清肌酐水平升高、严重蛋白尿和镜下血尿。移植肾活检标本显示为新月体性肾小球肾炎。免疫荧光显示主要为IgA和C3沿肾小球毛细血管壁和系膜区呈颗粒状沉积。电子显微镜显示广泛的上皮下和系膜电子致密沉积物。移植肾功能迅速且不可逆转地恶化，导致于1999年5月31日恢复血液透析。由于移植肾活检的组织病理学发现和临床症状，我们推测该病例是移植肾中一种非典型的新发过敏性紫癜性肾炎（HSPN）形式。
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