Moroni Gabriella, Papaccioli Daniela, Banfi Giovanni, Tarantino Antonio, Ponticelli Claudio
Division of Nephrology and Dialysis Ospedale Maggiore Policlinico IRCCS, Milan, Italy.
Am J Transplant. 2004 Jan;4(1):132-6. doi: 10.1046/j.1600-6135.2003.00283.x.
Only a few cases of acute post-infectious glomerulonephritis have been described in renal transplant patients. We report here three cases of acute post-bacterial glomerulonephritis in renal transplants. In contrast to the classic cases of post-streptococcal glomerulonephritis the type of infection was heterogeneous: respectively, Escherichia coli bacteremia, a skin abscess, and cholangitis. The clinical presentation was characterized by a deterioration of graft function in two of our three patients. Acute renal dysfunction recovered in both patients, but in the long term the outcome was severe; two of the three patients lost their graft function. It is difficult to ascertain whether progression was due to chronic allograft nephropathy, to glomerulonephritis, or both. It may be concluded that acute post-infectious glomerulonephritis is a possible, although rare, complication in renal transplant recipients. It has an unusual presentation and may have a poor outcome in the long term. The role of therapy, if any, is still undefined.
肾移植患者中仅有少数急性感染后肾小球肾炎病例被描述。我们在此报告3例肾移植术后急性细菌性肾小球肾炎病例。与经典的链球菌感染后肾小球肾炎病例不同，感染类型是异质性的：分别为大肠杆菌菌血症、皮肤脓肿和胆管炎。我们的3例患者中有2例临床表现为移植肾功能恶化。2例患者的急性肾功能障碍均恢复，但长期预后严重；3例患者中有2例失去了移植肾功能。很难确定病情进展是由于慢性移植肾肾病、肾小球肾炎，还是两者兼而有之。可以得出结论，急性感染后肾小球肾炎在肾移植受者中是一种可能发生的并发症，尽管罕见。它有不寻常的表现，长期预后可能较差。治疗（如果有作用的话）的作用仍不明确。
