Kato Maki, Nakazawa Eiko, Akimoto Tetsu, Inoue Makoto, Kanashiki Eriko, Meguro Daishi, Tozawa Ryoko, Muto Shigeaki, Yumura Wako, Kusano Eiji
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
Nihon Jinzo Gakkai Shi. 2009;51(5):569-75.
A case of nephrotic syndrome associated with bilateral hydronephrosis in a 26-year-old female is reported. She was referred to our hospital because of persistent diarrhea, abdominal pain, and urinary disorders. On admission, ascites, intestinal edema, and bilateral hydronephrosis, were demonstrated by radiographic analysis. The findings of both physical and laboratory examinations showed evidence of systemic lupus erythematosus (SLE). In addition, diffuse proliferative lupus nephritis was consistently confirmed by a renal biopsy. Immediately after the initiation of steroid treatment, her abdominal symptoms disappeared followed by an improvement in the symptoms of intestinal edema, hydronephrosis, and the renal function. The relationship between ureterohydronephrosis and lupus cystitis, and the fact that lupus enteritis is often associated with lupus cystitis have been demonstrated by previous studies. Finally, the clinical manifestations observed in our case led us to consider the association of lupus enteritis and cystitis. We should bear in mind the possible association of several disorders, including nephrotic syndrome, enteritis, and hydronephrosis due to cystitis, in cases presenting with SLE.
报告了一例26岁女性肾病综合征合并双侧肾积水的病例。她因持续腹泻、腹痛和泌尿系统疾病转诊至我院。入院时，影像学分析显示有腹水、肠道水肿和双侧肾积水。体格检查和实验室检查结果均显示有系统性红斑狼疮（SLE）的证据。此外，肾活检一直证实为弥漫性增殖性狼疮性肾炎。开始使用类固醇治疗后，她的腹部症状立即消失，随后肠道水肿、肾积水和肾功能症状有所改善。先前的研究已经证实了输尿管肾盂积水与狼疮性膀胱炎之间的关系，以及狼疮性肠炎常与狼疮性膀胱炎相关这一事实。最后，我们病例中观察到的临床表现使我们考虑狼疮性肠炎与膀胱炎的关联。对于出现SLE的病例，我们应牢记可能存在多种疾病的关联，包括肾病综合征、肠炎和膀胱炎所致的肾积水。
