Schoeneman M J, Ghali V, Lieberman K, Reisman L
Department of Pediatrics, Beth Israel Medical Center, New York, NY 10003.
Pediatr Nephrol. 1992 Jan;6(1):46-9. doi: 10.1007/BF00856831.
A 9-year-old boy is presented who was antibody positive for human immunodeficiency virus (HIV) and who had recurrent episodes of gross hematuria. Renal biopsy revealed findings typical of IgA nephropathy but also showed electron-microscopic abnormalities seen with HIV-associated nephropathy. In addition, IgA antibodies to multiple HIV proteins were detected in serum by Western blot analysis, and circulating immune complexes of the IgA class were present. Although HIV-associated nephropathy and IgA nephropathy are thought to be distinct conditions, five adults with a similar combination of findings have been reported, and our patient adds to the evidence for a link between these two entities in some patients. We propose that the histological parallels between the conditions may merely represent the limited renal responses available to multiple types of injuries, and we support the attempts underway to probe renal tissue for the HIV genome.
本文报告一名9岁男孩，其人类免疫缺陷病毒（HIV）抗体呈阳性，且反复出现肉眼血尿。肾活检显示出IgA肾病的典型表现，但也呈现出与HIV相关肾病所见的电子显微镜异常。此外，通过蛋白质印迹分析在血清中检测到针对多种HIV蛋白的IgA抗体，且存在IgA类循环免疫复合物。尽管HIV相关肾病和IgA肾病被认为是不同的病症，但已有报道称有五名成年人具有类似的综合表现，而我们的患者进一步证明了这两种病症在某些患者中存在关联。我们认为，这些病症在组织学上的相似之处可能仅仅代表了肾脏对多种类型损伤的有限反应，并且我们支持正在进行的探测肾组织中HIV基因组的尝试。
