Baba Akiko, Hara Seiichiro, Sato Yuji, Yamada Kazuhiro, Fujimoto Shouichi, Eto Tanenao
First Department of Internal Medicine, Miyazaki Medical College, University of Miyazaki, Miyazaki, Japan.
Nihon Jinzo Gakkai Shi. 2005;47(8):882-6.
We describe three females patients (age 40, 62 and 63 y) with nephrotic syndrome due to membranous nephropathy complicated by Sjögren's syndrome(SS). The patients satisfied the criteria for SS, but not those for systemic lupus erythematosus(SLE). All of them developed nephrotic syndrome, and light immunofluorescence as well as electron microscopy of renal biopsy specimens revealed membranous nephropathy. Two were positive for the SS-A antibody, and the other was positive for the SS-B antibody. Two were complicated with primary biliary cirrhosis (PBC) and autoimmune thyroiditis, whereas the other was complicated with interstitial pneumonia, but not with either PBC or autoimmune thyroiditis. Prednisolone (PSL) with or without cyclophosphamide improved the nephrotic syndrome in two of the patients. In conclusion, some patients with SS might become complicated with nephrotic syndrome due to membranous nephropathy if another systemic autoimmune disease exists.
我们描述了三名患有膜性肾病并发干燥综合征(SS)导致肾病综合征的女性患者(年龄分别为40岁、62岁和63岁)。这些患者符合SS的标准,但不符合系统性红斑狼疮(SLE)的标准。她们均出现了肾病综合征,肾活检标本的光镜免疫荧光及电镜检查均显示为膜性肾病。两名患者抗SS - A抗体阳性,另一名患者抗SS - B抗体阳性。两名患者合并原发性胆汁性肝硬化(PBC)和自身免疫性甲状腺炎,而另一名患者合并间质性肺炎,但未合并PBC或自身免疫性甲状腺炎。使用或未使用环磷酰胺的泼尼松龙(PSL)改善了两名患者的肾病综合征。总之,如果存在另一种全身性自身免疫性疾病,一些SS患者可能会并发膜性肾病导致的肾病综合征。