Lettgen B, Rascher W
Universitätsklinik Essen (GHS), Klinik für Kinder- und Jugendmedizin, Bundesrepublik Deutschland.
Klin Padiatr. 1991 Mar-Apr;203(2):124-8. doi: 10.1055/s-2007-1025414.
Four patients with acute renal failure during an acute course of IGA-nephritis are described. Percutaneous renal biopsies showed only minor glomerular lesions in all patients. Immunosuppressive therapy was not necessary. In all patients acute renal failure was completely reversible. The four patient showed further episodes of macrohematuria without acute renal failure. All patients had normal renal function, normotensive blood pressure and microhematuria during interval. In three of the patients we found erythrocytes casts and a mild protein excretion. IGA-nephritis is one of the most common types of glomerulonephritis in adolescents and adults. If acute renal failure occurs during a course of IGA-nephritis with macroscopic haematuria a percutaneous renal biopsy has to be performed. Only in case of severe crescents formation (greater than 75%) immunosuppressive therapy is necessary. Glomerular lesions are responsible for long time prognosis.
本文描述了4例在IgA肾病急性病程中出现急性肾衰竭的患者。经皮肾活检显示,所有患者仅存在轻微的肾小球病变。无需进行免疫抑制治疗。所有患者的急性肾衰竭均完全可逆。这4例患者出现了进一步的肉眼血尿发作,但未伴发急性肾衰竭。所有患者在病情间歇期肾功能正常、血压正常且存在镜下血尿。其中3例患者出现红细胞管型及轻度蛋白尿。IgA肾病是青少年和成人中最常见的肾小球肾炎类型之一。如果在IgA肾病伴有肉眼血尿的病程中发生急性肾衰竭,则必须进行经皮肾活检。仅在严重新月体形成(大于75%)的情况下才需要进行免疫抑制治疗。肾小球病变决定长期预后。