Eisenhut Michael, Jones Caroline, Hughes David, Herrington Simon, Kokai George
Royal Liverpool Children's Hospital, Eaton Road, Liverpool, L122AP, UK.
Pediatr Nephrol. 2004 Apr;19(4):448-50. doi: 10.1007/s00467-003-1344-5. Epub 2004 Jan 24.
We describe a 13-year-old boy who developed acute renal failure associated with Gemella haemolysans pneumonia. At presentation he was found to have macroscopic hematuria associated with lobar pneumonia. Gemella haemolysans was isolated from blood cultures. Renal failure was detected on admission, progressed and dialysis was required until day 18. Renal impairment had resolved by 3 months after the initial presentation. Histopathology of a renal biopsy showed focal proliferative glomerulonephritis, but the predominant abnormality was tubular damage associated with erythrocyte casts in tubular lumina. We believe that tubular damage due to hematuria rather than the glomerular changes was the most likely cause of renal failure.
我们描述了一名13岁男孩,他患溶血性孪生球菌肺炎并伴有急性肾衰竭。就诊时发现他患有大叶性肺炎伴肉眼血尿。血培养分离出溶血性孪生球菌。入院时检测到肾衰竭,病情进展,直到第18天需要进行透析。初次就诊后3个月肾功能损害已消退。肾活检的组织病理学显示局灶性增生性肾小球肾炎,但主要异常是肾小管损伤,管腔内有红细胞管型。我们认为,肾衰竭最可能的原因是血尿导致的肾小管损伤,而非肾小球改变。