Lee Ji Myoung, Lee Kang Moon, Kim Hyung Wook, Chung Woo Chul, Paik Chang Nyol, Lee Jeong Rok, Choi Yeong Jin, Yang Jin Mo
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Korean J Gastroenterol. 2008 Aug;52(2):115-9.
Urological complications are not uncommon in Crohn's disease (CD). The most common manifestations are renal stones, enterovesical fistulas, and ureteral obstruction, but renal parenchymal disease has rarely been reported. IgA nephropathy, the most common form of primary glomerulonephritis, is usually isolated, but can be sometimes associated with chronic extrarenal disorders such as inflammatory bowel disease. We describe a case of 36 year-old man with CD associated with IgA nephropathy. He was diagnosed as CD 6 years ago and at that time, isolated proteinuria was observed. He presented recurrent proteinuria and elevation of creatinine level while he had been managed well with mesalamine and azathioprine. The renal biopsy was performed and IgA nephropathy (type IV) was diagnosed. Strict blood pressure control with angiotensin converting enzyme inhibitor and calcium channel blocker resulted in clinical improvement and normalization of serum creatinine level.
泌尿系统并发症在克罗恩病(CD)中并不少见。最常见的表现是肾结石、肠膀胱瘘和输尿管梗阻,但肾实质疾病鲜有报道。IgA肾病是原发性肾小球肾炎最常见的形式,通常为孤立性,但有时可与慢性肾外疾病如炎症性肠病相关。我们描述了一例36岁患有CD并伴有IgA肾病的男性患者。他6年前被诊断为CD,当时发现有孤立性蛋白尿。在使用美沙拉嗪和硫唑嘌呤治疗效果良好的情况下,他出现了复发性蛋白尿和肌酐水平升高。进行了肾活检,诊断为IgA肾病(IV型)。使用血管紧张素转换酶抑制剂和钙通道阻滞剂严格控制血压,使临床症状改善,血清肌酐水平恢复正常。