Suzuki Satoshi, Konta Tsuneo, Koizumi Ryo, Nishida Wakako, Abiko Hiroshi, Kubota Isao
First Department of Internal Medicine, Yamagata University School of Medicine, Yamagata.
Intern Med. 2003 Aug;42(8):719-22. doi: 10.2169/internalmedicine.42.719.
A 59-year-old man was referred for evaluation of nephrotic syndrome. The patient was diagnosed to have rheumatoid arthritis and had been treated for 10 years. Renal biopsy showed mesangial proliferation with small nodular formations, which were determined as fibrillary deposits (average diameter: 20 nm) by electromicroscopy. Congo-red stain was negative. The laboratory findings revealed hypocomplementemia and lambda type of Bence-Jones protein in urine without other systemic diseases including multiple myeloma. Immunosuppressive therapy did not attenuate the nephrotic-range proteinuria. Such a case of fibrillary glomerulonephritis with hypocomplementemia is rare.
一名59岁男性因肾病综合征接受评估。该患者被诊断为类风湿关节炎，已接受治疗10年。肾活检显示系膜增生伴小结节形成，电镜检查确定为纤维状沉积物（平均直径：20nm）。刚果红染色为阴性。实验室检查结果显示低补体血症，尿中出现λ型本周氏蛋白，无包括多发性骨髓瘤在内的其他全身性疾病。免疫抑制治疗未能减轻肾病范围的蛋白尿。这种伴有低补体血症的纤维性肾小球肾炎病例罕见。
