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[过敏机制在微小病变型肾病综合征(MCNS)中的作用]

[Involvement of allergic mechanism in minimal change nephrotic syndrome (MCNS)].

作者信息

Boku S, Shinbo H, Akagi T, Totsuka D, Shibata T, Saito K, Kitazawa K, Ito S, Sugisaki T

机构信息

Department of Nephrology, Showa University School of Medicine.

出版信息

Arerugi. 1992 Oct;41(10):1492-9.

PMID:1482298
Abstract

In this study we evaluated the involvement of allergic mechanisms in patients with adult onset MCNS (17 cases) by measuring serum IgE levels and RAST scores to house dust 1 (H.D.1), house dust 2 (H.D.2), Dermatophagoides farinae (D.f.), Dermatophagoides ptenonyssinus (D.p.). Out of the 17 cases, three cases showed high levels of IgE (more than 1000 IU/ml) and the mean level of serum IgE was 877 IU/ml before treatment. All cases were treated with steroid and/or cyclophosphamide. After the treatment, all cases returned to remission. The level of IgE decreased to the normal range in four out of seven cases which had shown high levels of IgE before treatment. RAST was carried out on seven of the 17 cases. RAST scores for D.f. and D.f. were found to be positive in three cases, but these became negative in two cases after treatment. In five cases relapsed, the all cases showed to have the increased level of serum IgE and two of four cases which were examined RAST score showed to have the increased RAST score for D.f. and D.p. Thus, the data indicated that allergic mechanism, especially against D.f. and D.p. antigen, seemed to play one of the factors in the pathogenesis of MCNS.

摘要

在本研究中,我们通过测量血清IgE水平以及针对屋尘1(H.D.1)、屋尘2(H.D.2)、粉尘螨(D.f.)、户尘螨(D.p.)的放射变应原吸附试验(RAST)评分,评估了成年起病的微小病变性肾病综合征(MCNS)患者(17例)中过敏机制的参与情况。17例患者中,3例IgE水平较高(超过1000 IU/ml),治疗前血清IgE的平均水平为877 IU/ml。所有病例均接受了类固醇和/或环磷酰胺治疗。治疗后,所有病例均恢复缓解。治疗前IgE水平较高的7例患者中,有4例IgE水平降至正常范围。对17例患者中的7例进行了RAST检测。发现3例患者针对D.f.和D.p.的RAST评分呈阳性,但治疗后有2例转为阴性。在5例复发的病例中,所有病例血清IgE水平均升高,接受RAST评分检测的4例病例中有2例针对D.f.和D.p.的RAST评分升高。因此,数据表明过敏机制,尤其是针对D.f.和D.p.抗原的过敏机制,似乎在MCNS的发病机制中起到了一定作用。

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