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[一名患有 IBL 样 T 细胞淋巴瘤的患者因毛细血管内增生性肾小球肾炎导致急性肾衰竭]

[Acute renal failure due to endocapillary proliferative glomerulonephritis in a patient with IBL-like T-cell lymphoma].

作者信息

Yamazaki Y, Inaba S, Nemoto T, Iizuka K, Fujikawa T, Horiguchi J, Yamada H

机构信息

Department of Internal Medicine, Aoto Hospital, School of Medicine Jikei University.

出版信息

Rinsho Ketsueki. 1991 Jul;32(7):796-801.

PMID:1920845
Abstract

A 72-year-old man was admitted of generalized lymphadenopathy and oliguria on December 12, 1987. Laboratory findings revealed progressive renal impairment, polyclonal hypergammaglobulinemia, and reduction of serum complements. A cervical lymph node was typically suitable for histology of IBL-like T-cell lymphoma. The surface markers of lymph node were mainly CD2 (+) and CD3 (+) and clonal proliferation of lymphoma cells was proved by TCR-beta gene rearrangement. Renal biopsy to examine the pathogenesis of acute renal failure revealed endocapillary proliferative glomerulonephritis without invasion of lymphoma cells. Both lymphadenopathy and renal failure were improved by successful administration of prednisolone and hemodialysis. Although relapsed tumor was partially responded to vincristine and prednisolone, he died of alimentary tract bleeding. We reported a case of IBL-like T-cell lymphoma with acute renal failure due to endocapillary proliferative glomerulonephritis.

摘要

1987年12月12日,一名72岁男性因全身淋巴结肿大和少尿入院。实验室检查结果显示进行性肾功能损害、多克隆高球蛋白血症和血清补体降低。一个颈部淋巴结是典型的适合进行间变性大细胞淋巴瘤样T细胞淋巴瘤组织学检查的标本。淋巴结的表面标志物主要为CD2(+)和CD3(+),TCR-β基因重排证实淋巴瘤细胞存在克隆性增殖。肾活检以检查急性肾衰竭的发病机制,结果显示为毛细血管内增生性肾小球肾炎,未见淋巴瘤细胞浸润。成功给予泼尼松龙和血液透析后,淋巴结肿大和肾衰竭均得到改善。尽管复发性肿瘤对长春新碱和泼尼松龙有部分反应,但患者最终死于消化道出血。我们报告了一例因毛细血管内增生性肾小球肾炎导致急性肾衰竭的间变性大细胞淋巴瘤样T细胞淋巴瘤病例。

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