Sekine Shizue, Yumura Wako, Tanaka Yuko, Suganuma Shinya, Onuki Takako, Uchida Keiko, Kawashima Akira, Honda Kazuho, Nitta Kosaku, Nihei Hiroshi
Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
Nihon Jinzo Gakkai Shi. 2002 Jan;44(1):44-9.
We report a rare case of nephrotic syndrome in an elderly woman with positive antineutrophil cytoplasmic antibody(ANCA). The patient was 81 years of age and had a history of interstitial pneumonia. She was diagnosed rheumatoid arthritis(RA) at admission. Rapidly progressing renal damage was found with mild microscopic hematuria and positive ANCA. The renal biopsy findings indicated membranous nephropathy. Neither gold nor anti-rheumatic drugs had been previously administered. She may have had an RA-specific membranous nephropathy. Crescentic formation was not clear. With hematuria, the leukocyte infiltration in the capillary lumen and the change in epithelial cells of Bowman's capsules would be histological findings suggesting ANCA-associated nephritis. This is a rare report on membranous nephropathy in an RA patient with ANCA-associated nephritis.
我们报告了一例罕见的老年女性肾病综合征病例，该患者抗中性粒细胞胞浆抗体（ANCA）呈阳性。患者81岁，有间质性肺炎病史。入院时被诊断为类风湿关节炎（RA）。发现有轻度镜下血尿和ANCA阳性，肾脏损害进展迅速。肾活检结果显示为膜性肾病。此前未使用过金制剂或抗风湿药物。她可能患有RA特异性膜性肾病。新月体形成不明显。伴有血尿时，毛细血管腔内的白细胞浸润以及鲍曼囊上皮细胞的变化将是提示ANCA相关性肾炎的组织学表现。这是一篇关于伴有ANCA相关性肾炎的RA患者发生膜性肾病的罕见报告。
