Néphrologie Pédiatrique-Centre de Référence des Maladies Rénales Rares du Sud-Ouest-CHU Montpellier, Université Montpellier I, Montpellier, France.
Pediatr Nephrol. 2010 Sep;25(9):1765-9. doi: 10.1007/s00467-010-1491-4. Epub 2010 Mar 25.
Mycoplasma pneumoniae-associated nephritis has been reported in children with various pathological findings. It nevertheless remains an uncommon disease and, within this clinical context, endo-and extracapillary glomerulonephritis in a child has never been described. We report here a case of a 3-year-old girl diagnosed with severe crescentic glomerulonephritis associated with M. pneumoniae infection who presented with nephrotic syndrome and impaired renal function. The serum C3 complement level was initially low but returned to normal after 1 month. Two courses of three methylprednisolone pulses were administered in association with plasmapheresis and, secondarily, mycophenolate mophetil. This treatment regimen led to disease remission and a favorable renal outcome at the 6-month follow-up. However, the treatment guidelines in this situation remain debatable.
肺炎支原体相关性肾炎在儿童中已有多种病理发现的报道。然而，它仍然是一种罕见的疾病，在这种临床情况下，儿童的内皮下和毛细血管内肾小球肾炎从未被描述过。我们在此报告一例 3 岁女孩，被诊断为严重的新月体性肾小球肾炎伴肺炎支原体感染，表现为肾病综合征和肾功能受损。血清 C3 补体水平最初较低，但在 1 个月后恢复正常。在接受血浆置换和随后的吗替麦考酚酯治疗的同时，给予了两疗程三次甲泼尼龙脉冲治疗。该治疗方案使疾病得到缓解，在 6 个月的随访时肾脏预后良好。然而，这种情况下的治疗指南仍存在争议。
