Kuroda Takeshi, Ueno Mitsuhiro, Sato Hiroe, Murakami Syuuichi, Sakatsume Minoru, Nishi Shinichi, Nakano Masaaki, Gejyo Fumitake
Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Niigata City, 951-8510, Japan.
Rheumatol Int. 2006 Nov;27(1):103-7. doi: 10.1007/s00296-006-0156-x. Epub 2006 Jul 8.
In this report, we describe the case of a 50-year-old Japanese woman with Takayasu arteritis who developed severe proteinuria and renal dysfunction. Abdominal computed tomography did not show narrowing of both renal arteries. Although her levels of C-reactive protein were negative, plasma vascular endothelial growth factor (VEGF) and serum interleukin (IL)-6 levels were elevated. Renal biopsy showed glomerulonephropathy mimicking membranoproliferative glomerulonephritis (MPGN) with glomerular capillary wall thickening (double contour). This was accompanied by mesangial cell proliferation and moderate increase of mesangial matrix without deposits of C3. These findings are quite different from MPGN as electron microscopy did not show subendothelial deposit and circumferential mesangial interposition. Here, we present the case of Takayasu arteritis associated with MPGN-like renal manifestation and elevated VEGF and IL-6. The presence of elevated VEGF and IL-6 could be factors that might contribute to MPGN-like appearance.
在本报告中，我们描述了一名50岁患高安动脉炎的日本女性病例，该患者出现了严重蛋白尿和肾功能不全。腹部计算机断层扫描未显示双侧肾动脉狭窄。尽管她的C反应蛋白水平为阴性，但血浆血管内皮生长因子（VEGF）和血清白细胞介素（IL）-6水平升高。肾活检显示肾小球肾炎类似膜增生性肾小球肾炎（MPGN），伴有肾小球毛细血管壁增厚（双轨征）。这伴有系膜细胞增殖和系膜基质中度增加，无C3沉积。这些发现与MPGN有很大不同，因为电子显微镜未显示内皮下沉积物和系膜周围插入。在此，我们展示了伴有MPGN样肾脏表现及VEGF和IL-6升高的高安动脉炎病例。VEGF和IL-6升高可能是导致MPGN样表现的因素。
