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乳糜泻相关性膜性肾病——罕见病因还是巧合?一例报告。

Celiac disease associated membranous nephropathy - a rare cause or coincidence? A case report.

作者信息

Prasad Deepali, Khara Harshit S, Gupta Mohit, Sterman Paul

机构信息

Department of Internal Medicine, Drexel University College of Medicine - Saint Peter's University Hospital, 254 Easton Avenue, New Brunswick, NJ 08901, USA.

出版信息

Cases J. 2009 Jun 18;2:7018. doi: 10.4076/1757-1626-2-7018.

Abstract

INTRODUCTION

Celiac disease is associated with a variety of autoimmune diseases such as type 1 diabetes mellitus, autoimmune thyroid disorders, Sjogren's syndrome and IgA nephropathy, however membranous nephropathy is not recognized amongst one of them.

CASE PRESENTATION

We report a rare case of nephrotic syndrome due to membranous nephropathy in a patient with celiac disease. A 77-years-old male patient presented with uncontrolled hypertension, anemia and acute renal failure. He was diagnosed with celiac disease and membranous nephropathy confirmed by small bowel and renal biopsy. Patient was treated with gluten free diet and immuno-suppressive therapy; however, he died within 2 to 3 months due to myocardial infarction.

CONCLUSION

The association between celiac disease and nephrotic syndrome is extremely rare. Only two adult patients with celiac disease and membranous nephropathy have been reported in the literature so far. Since the prevalence of celiac disease ranges between 0.75% and 4.54%, the question arises whether the coexistence of celiac disease and membranous nephropathy is just a coincidence or a rare association. As they both are immune mediated diseases, a link between them is a strong possibility.

摘要

引言

乳糜泻与多种自身免疫性疾病相关,如1型糖尿病、自身免疫性甲状腺疾病、干燥综合征和IgA肾病,然而膜性肾病并不在其中。

病例报告

我们报告了一例乳糜泻患者并发膜性肾病导致肾病综合征的罕见病例。一名77岁男性患者出现难以控制的高血压、贫血和急性肾衰竭。经小肠和肾活检确诊为乳糜泻和膜性肾病。患者接受了无麸质饮食和免疫抑制治疗;然而,他在2至3个月内因心肌梗死死亡。

结论

乳糜泻与肾病综合征之间的关联极为罕见。迄今为止,文献中仅报道了两例成年乳糜泻合并膜性肾病患者。由于乳糜泻的患病率在0.75%至4.54%之间,因此出现了一个问题,即乳糜泻和膜性肾病的共存究竟是巧合还是罕见的关联。鉴于它们都是免疫介导的疾病,两者之间存在联系的可能性很大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4073/2740114/da8f2fa27b40/1757-1626-0002-0000007018-001.jpg

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