Iwatani Hirotsugu, Uzu Takashi, Kakihara Masahiro, Nakayama Yuji, Kanasaki Keizo, Yamato Masaya, Hirai Yasuhiro, Umimoto Koichi, Yamauchi Atsushi
Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine (A8), 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Clin Exp Nephrol. 2004 Dec;8(4):369-74. doi: 10.1007/s10157-004-0321-z.
We report a case of a 41-year-old Japanese man who presented with rapidly progressive glomerulonephritis, chronic sinusitis, and positive cytoplasmic-antineutrophil cytoplasmic antibody (c-ANCA). Renal biopsy showed crescentic glomerulonephritis, and he was diagnosed as having Wegener's granulomatosis. During the clinical course, he suffered from pulmonary bleeding, and combination therapy of steroid, immunosuppressant, and double filtration plasmapheresis (DFPP) was started. He rapidly entered remission after assistance through DFPP, suggesting the potential efficacy of DFPP for Wegener's granulomatosis, especially with pulmonary bleeding.
我们报告一例41岁的日本男性患者,其表现为快速进展性肾小球肾炎、慢性鼻窦炎,且胞浆型抗中性粒细胞胞浆抗体(c-ANCA)呈阳性。肾活检显示为新月体性肾小球肾炎,他被诊断为韦格纳肉芽肿。在临床过程中,他出现了肺出血,于是开始了类固醇、免疫抑制剂及双重滤过血浆置换(DFPP)的联合治疗。通过DFPP辅助后,他迅速进入缓解期,这表明DFPP对韦格纳肉芽肿,尤其是伴有肺出血的情况可能有效。