Kwan J T, Moore R H, Dodd S M, Cunningham J
Department of Nephrology, Royal London Hospital, Whitechapel, UK.
Postgrad Med J. 1991 Jun;67(788):574-6. doi: 10.1136/pgmj.67.788.574.
A 31 year old man first developed steroid-resistant idiopathic membranous glomerulonephritis in 1981. Stable normal renal function was maintained until August 1988 when he suffered a clinical relapse with heavy proteinuria and declining renal function. Immunosuppressive therapy with prednisolone and cyclophosphamide was instituted in an attempt to arrest this relapse. Despite this, he later developed acute renal failure with histological evidence of crescentic transformation of his nephritis. This unusual transformation was not associated with features of systemic vasculitis or positive anti-glomerular basement membrane and anti-neutrophil cytoplasmic antibodies.
一名31岁男性于1981年首次出现类固醇抵抗性特发性膜性肾小球肾炎。直到1988年8月，他的肾功能一直保持稳定正常，当时他出现临床复发，伴有大量蛋白尿和肾功能下降。采用泼尼松龙和环磷酰胺进行免疫抑制治疗，试图阻止这种复发。尽管如此，他后来仍发展为急性肾衰竭，肾组织学检查显示肾炎有新月体形成。这种不寻常的转变与系统性血管炎的特征、抗肾小球基底膜抗体和抗中性粒细胞胞浆抗体阳性无关。
