Niwa T, Miyazaki T, Emoto Y, Yazawa T, Naoe T, Maeda K
Department of Internal Medicine, Nagoya University Branch Hospital, Japan.
Nihon Jinzo Gakkai Shi. 1991 May;33(5):533-8.
A case of lupus nephritis showing rectal erosion with cytomegalovirus infection is described. The patient revealed nephrotic syndrome. She complained of skin ulcer with livedo reticularis on the right breast, purpura with thrombocytopenia, hepatic dysfunction, and bloody stool. Renal biopsy demonstrated diffuse proliferative lupus nephritis with prominent wire loops. Intestinal fiberscopy showed rectal erosion which was a cause of bloody stool, and rectal biopsy revealed cytomegalic inclusions characteristic of cytomegalovirus infection. Immunosuppression due to combined therapy with prednisolone and mizoribine could have led to reactivation of latent cytomegalovirus infection, resulting in the rectal erosion with bloody stool.
本文描述了一例狼疮性肾炎合并巨细胞病毒感染导致直肠糜烂的病例。该患者表现为肾病综合征。她主诉右乳出现伴有网状青斑的皮肤溃疡、血小板减少性紫癜、肝功能障碍及便血。肾活检显示为伴有显著白金耳的弥漫增生性狼疮性肾炎。肠道纤维内镜检查显示直肠糜烂是便血的原因，直肠活检发现具有巨细胞病毒感染特征的巨细胞包涵体。泼尼松龙和咪唑立宾联合治疗引起的免疫抑制可能导致潜伏的巨细胞病毒感染重新激活，进而导致直肠糜烂并便血。
