Iwata Yasunori, Wada Takashi, Uchiyama Akio, Miwa Atsuo, Nakaya Izaya, Tohyama Tadashi, Yamada Yuhji, Kurokawa Toshiro, Yoshida Takashi, Ohta Satoshi, Yokoyama Hitoshi, Iida Hiroyuki
Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama, Japan.
Intern Med. 2006;45(22):1291-5. doi: 10.2169/internalmedicine.45.1837. Epub 2006 Dec 15.
We report a case with immunoglobulin A (IgA) nephropathy, showing IgA deposition which disappeared after peripheral blood stem cell transplantation (PBSCT) for acute lymphocytic leukemia (ALL). In 1996, a 28-year-old man was diagnosed with IgA nephropathy by renal biopsy. Steroid therapy improved proteinuria from 3 g/day to 1 g/day. In 2003, he received PBSCT following the initial therapy for ALL. After complete remission, urinary protein and hematuria remained at between (-) and (+/-). In 2004, the second renal biopsy specimen revealed no deposit of IgA or C3. These findings suggested that immune reconstruction with PBSCT following immunosuppression therapy was of benefit to IgA nephropathy.
我们报告一例免疫球蛋白A（IgA）肾病患者，其IgA沉积在接受急性淋巴细胞白血病（ALL）外周血干细胞移植（PBSCT）后消失。1996年，一名28岁男性经肾活检确诊为IgA肾病。类固醇治疗使蛋白尿从每日3克降至每日1克。2003年，他在接受ALL初始治疗后接受了PBSCT。完全缓解后，尿蛋白和血尿维持在（-）至（+/-）之间。2004年，第二次肾活检标本显示无IgA或C3沉积。这些发现提示，免疫抑制治疗后进行PBSCT的免疫重建对IgA肾病有益。
