Hodgin Jeffrey B, Whelan Joseph, Markowitz Glen S, Stokes M Barry
Department of Pathology, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
Am J Kidney Dis. 2009 Mar;53(3):513-7. doi: 10.1053/j.ajkd.2008.09.015. Epub 2008 Nov 6.
We report a case of acute tubulointerstitial nephritis with giant cell tubulitis and tubular basement membrane immune complex deposits in a patient with membranous lupus nephritis. The patient, who had no prior evidence of lupus nephritis, developed acute kidney failure and mild proteinuria after cardiac valve replacement surgery. Giant cell tubulitis with tubular basement membrane immune complex deposits has been described in 4 patients after cardiac surgery, 3 of whom received cefuroxime, suggesting the possibility of a drug hypersensitivity reaction. The present case suggests there may also be a pathogenetic role for autoimmunity in this condition.
我们报告了一例患有膜性狼疮性肾炎的患者发生急性肾小管间质性肾炎，伴有巨细胞肾小管炎和肾小管基底膜免疫复合物沉积。该患者既往无狼疮性肾炎证据，在心脏瓣膜置换术后出现急性肾衰竭和轻度蛋白尿。心脏手术后有4例患者出现了伴有肾小管基底膜免疫复合物沉积的巨细胞肾小管炎，其中3例接受了头孢呋辛治疗，提示可能存在药物过敏反应。本病例表明，自身免疫在这种情况下也可能起致病作用。
