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膜性肾小球肾炎与慢性炎症性脱髓鞘性多发性神经根神经病并存:对自身免疫假说的质疑

Coincident membranous glomerulonephritis and chronic inflammatory demyelinating polyradiculoneuropathy: questioning the autoimmunity hypothesis.

作者信息

Smyth Shane, Menkes Daniel L

机构信息

Department of Neurology, University of Tennessee Health Sciences Center at Memphis, 855 Monroe Avenue, Link 415, Memphis, Tennessee 38163, USA.

出版信息

Muscle Nerve. 2008 Jan;37(1):130-5. doi: 10.1002/mus.20841.

Abstract

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and membranous glomerulonephritis (MGN) are both autoimmune disorders that are rarely observed concurrently. We describe a patient who developed MGN nearly 20 years after the onset of CIDP, resulting in a secondary progression of his neuropathy. He responded dramatically to a novel regimen of plasma exchange and methotrexate. We propose a mechanism other than autoimmunity for the coincidence of these disorders and discuss the theoretical superiority of the treatment regimen that he received.

摘要

慢性炎症性脱髓鞘性多发性神经根神经病(CIDP)和膜性肾小球肾炎(MGN)均为自身免疫性疾病,很少同时出现。我们描述了一名患者,在CIDP发病近20年后发生了MGN,导致其神经病变继发进展。他对一种新的血浆置换和甲氨蝶呤治疗方案反应显著。我们提出了一种不同于自身免疫的机制来解释这些疾病的巧合,并讨论了他所接受治疗方案的理论优势。

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