Osborne C A, Hammer R F, Resnick J S, Stevens J B, Yano B L, Vernier R L
J Am Vet Med Assoc. 1976 Jan 15;168(2):129-37.
A nephrotic syndrome caused by immune-complex glomerular disease was diagnosed in a 4-year-old male Great Dane. The syndrome was characterized by proteinuria, hypoproteinemia, hypoalbuminemia, hypercholesterolemia, and subcutaneous edema. Renal biopsy revealed segmental membranous glomerular disease. The edema underwent complete remission 18 days after admission. Two months after admission, there was no clinical or laboratory evidence of glomerular disease. Periodic reevaluation of the dog during the next 2 years revealed recurrence of proteinuria, but no other clinical or laboratory abnormalities. Serial renal biopsies revealed persistence, but no appreciable increase, in the severity of the segmental membranous glomerular disease. The natural course of the nephrotic syndrome and immune-complex glomerular disease has been associated with unpredictable variability. It was concluded that the widespread use of corticosteroid or immunosuppressant therapy in dogs with immune complex glomerular disease should be withheld until the natural course of the disease has been evaluated in a significant number of patients and until the results of well-controlled clinical studies confirm or deny their therapeutic value.
一只4岁的雄性大丹犬被诊断出患有由免疫复合物肾小球疾病引起的肾病综合征。该综合征的特征为蛋白尿、低蛋白血症、低白蛋白血症、高胆固醇血症和皮下水肿。肾活检显示为节段性膜性肾小球疾病。入院18天后水肿完全消退。入院两个月后，没有肾小球疾病的临床或实验室证据。在接下来的2年中对该犬进行定期重新评估，发现蛋白尿复发，但无其他临床或实验室异常。系列肾活检显示节段性膜性肾小球疾病的严重程度持续存在，但无明显增加。肾病综合征和免疫复合物肾小球疾病的自然病程具有不可预测的变异性。得出的结论是，在对大量患者评估该疾病的自然病程并且对照良好的临床研究结果证实或否定其治疗价值之前，应避免在患有免疫复合物肾小球疾病的犬中广泛使用皮质类固醇或免疫抑制疗法。
