Jimbo R, Ubara Y, Tagami T, Higa Y, Suwabe T, Nakanishi S, Sogawa Y, Nomura K, Kadoguchi H, Hoshino J, Sawa N, Katori H, Takemoto F, Hara S, Hara S, Ohashi K, Takaichi K
Nephrology Center, Toranomon Hospital, Tokyo, Japan.
Clin Nephrol. 2007 Aug;68(2):104-8. doi: 10.5414/cnp68104.
Antineutrophil cytoplasmic antibody-(ANCA) associated glomerulonephritis usually shows histopathologic features of pauciimmune crescentic glomerulonephritis and occurs late in life. We report a 14-year-old Japanese girl presenting with proteinuria, hematuria and mildly elevated serum creatinine. A renal biopsy specimen demonstrated crescentic glomerulonephritis, immunofluorescence showed mesangial IgA staining. Electron microscopic examination disclosed paramesangial deposits. Serum ANCA against myeloperoxidase (MPO) were detected at high titers. Myeloperoxidase-ANCA-related nephritis accompanied by IgA nephropathy is considered rare in childhood and teen years. Yet, if ANCA assays and detailed electron microscopic examination of renal specimens were performed routinely in patients with rapidly progressive glomerulonephritis, the diagnosis might be more frequent in young patients.
抗中性粒细胞胞浆抗体(ANCA)相关肾小球肾炎通常表现为少免疫性新月体性肾小球肾炎的组织病理学特征,且发病较晚。我们报告一名14岁日本女孩,出现蛋白尿、血尿和血清肌酐轻度升高。肾活检标本显示新月体性肾小球肾炎,免疫荧光显示系膜IgA染色。电子显微镜检查发现系膜旁沉积物。检测到高滴度的抗髓过氧化物酶(MPO)血清ANCA。在儿童和青少年中,髓过氧化物酶-ANCA相关肾炎伴IgA肾病被认为较为罕见。然而,如果对快速进展性肾小球肾炎患者常规进行ANCA检测和肾标本的详细电子显微镜检查,在年轻患者中诊断可能会更常见。