Heras Manuel, Iglesias Pedro, Fernández-Reyes María J, Sánchez Rosa, Jiménez María J, Muñoz Henar, Tajada Pilar, Duarte Jacinto
Department of Nephrology, Hospital General, Segovia, Spain.
Am J Kidney Dis. 2008 Jun;51(6):1025-8. doi: 10.1053/j.ajkd.2008.02.310. Epub 2008 May 2.
We report for the first time a case of nephrotic-range proteinuria adequately controlled by using dopamine agonists. A 40-year-old man was studied because of persistent asymptomatic nephrotic proteinuria despite lifestyle modifications and treatment with converting enzyme inhibitors. The renal biopsy specimen did not show histopathologic changes. In the follow-up period, a giant prolactinoma was found by chance with extremely high prolactin (PRL) values. After establishing cabergoline therapy, we achieved a remarkable decrease in both serum PRL levels and tumor mass, and surprisingly, proteinuria disappeared. We discuss the possible pathogenic mechanisms of proteinuria that may correspond to PRL level in urine (prolactinuria) or another tumor-related protein.
我们首次报告了一例使用多巴胺激动剂可充分控制肾病范围蛋白尿的病例。一名40岁男性因尽管改变生活方式并使用转换酶抑制剂治疗仍持续存在无症状性肾病性蛋白尿而接受研究。肾活检标本未显示组织病理学改变。在随访期间,偶然发现巨大泌乳素瘤,泌乳素(PRL)值极高。确立卡麦角林治疗后,我们使血清PRL水平和肿瘤体积均显著降低,令人惊讶的是,蛋白尿消失了。我们讨论了蛋白尿可能的致病机制,其可能与尿中PRL水平(泌乳素尿)或另一种肿瘤相关蛋白有关。