Singh N P, Gulati S, Garg V, Beniwal P, Garg S
Department of Medicine, Maulana Azad Medical College, New Delhi-110 002, India.
Indian J Nephrol. 2008 Oct;18(4):169-72. doi: 10.4103/0971-4065.45294.
The three broad groups of rapidly progressing glomerulonephritis are anti glomerular basement membrane (anti-GBM) disease, renal vasculitis characterized by antineutrophil cytoplasmic antibody positivity, and a heterogeneous group with granular immune deposits. Anti-GBM disease with cytoplasmic antineutrophilic antibodies (c-ANCA) positivity (type III disease) is not known to present with nephrotic syndrome. We report here a rare presentation of nephrotic syndrome in Type III disease. Larger studies are warranted to determine whether the amount and/or type of immune deposits decide the range of proteinuria. These studies are also required to elucidate the impact of immune complex deposition on renal disease in c-ANCA-positive glomerulonephritis and to outline its pathogenetic mechanism.
抗肾小球基底膜（抗GBM）病、以抗中性粒细胞胞浆抗体阳性为特征的肾血管炎以及具有颗粒状免疫沉积物的异质性组。抗GBM病合并胞浆抗中性粒细胞抗体（c-ANCA）阳性（III型疾病）一般不会表现为肾病综合征。我们在此报告III型疾病中罕见的肾病综合征表现。需要开展更大规模的研究，以确定免疫沉积物的数量和/或类型是否决定蛋白尿的范围。还需要这些研究来阐明免疫复合物沉积对c-ANCA阳性肾小球肾炎肾脏疾病的影响，并概述其发病机制。
