Shimohata Homare, Yoh Keigyou, Takada Kenji, Tanaka Hiroaki, Usui Joichi, Hirayama Kouichi, Kobayashi Masaki, Yamagata Kunihiro
Department of Nephrology, Tokyo Medical University, Ibaraki Medical Center, Ibaraki, Japan.
J Nephrol. 2009 Sep-Oct;22(5):682-4.
We present a 22-year-old male patient who showed both classical Fabry disease and IgA nephropathy. He had proteinuria (1.5 g/day), hypohidrosis and neuralgia with fever. Serum creatinine and blood urea nitrogen were 0.9 mg/dL and 11.4 mg/dL, respectively. Renal biopsy showed strikingly vacuolated podocytes and tubular epithelium cells. Myelin-like bodies were detected in podocytes, mesangial cells, endothelial cells and tubular epithelium cells by electron microscopy. On immunofluorescence microscopy, IgA and C3 deposits were detected in mesangial areas. From these results and a markedly low level of alpha-galactosidase A activity, this patient was diagnosed as having classical Fabry disease and IgA nephropathy.
我们报告一名22岁男性患者,其同时表现出典型的法布里病和IgA肾病。他有蛋白尿(1.5克/天)、少汗症以及伴有发热的神经痛。血清肌酐和血尿素氮分别为0.9毫克/分升和11.4毫克/分升。肾活检显示足细胞和肾小管上皮细胞有明显的空泡形成。通过电子显微镜在足细胞、系膜细胞、内皮细胞和肾小管上皮细胞中检测到髓鞘样小体。在免疫荧光显微镜下,在系膜区检测到IgA和C3沉积。根据这些结果以及显著降低的α-半乳糖苷酶A活性,该患者被诊断为患有典型的法布里病和IgA肾病。