Op den Winkel M, Gülberg V, Weiss M, Ebeling F, Gerbes A L, Samtleben W
Department of Medicine II, University-Hospital Munich-Großhadern, Ludwig-Maximilians-University, Munich, Germany.
Clin Nephrol. 2010 Dec;74(6):474-9.
Kidney disease is a rare complication of Campylobacter jejuni (C. jejuni) enteritis. We here present the case of an 18-year-old male patient with crampy abdominal pain, vomiting, diarrhea, and fever. Three weeks later urinalysis revealed mild proteinuria and hematuria and a marked raise in serum creatinine was observed. Renal biopsy demonstrated acute endocapillary glomerulonephritis with mesangial IgM (immunoglobuline M) deposits. Extensive workup revealed no signs of skin or joint disease, thus excluding Henoch-Schönlein purpura. Due to persistent abdominal discomfort further gastro-enterological tests were performed and eventually Campylobacter jejuni was isolated from the patient's feces. In the absence of other precipitating factors for renal diseases we presumed an association between the bacterial infection and this postinfectious glomerulonephritis. Over a time period of 6 months the patient's kidney function normalized completely. However, long-term prognosis remains unclear. In addition to the case report, we conducted a review of the literature with results underlining Campylobacter jejuni's potential to trigger various types of immune mediated kidney diseases.
肾脏疾病是空肠弯曲菌肠炎的一种罕见并发症。我们在此报告一例18岁男性患者，其出现腹部绞痛、呕吐、腹泻和发热症状。三周后，尿液分析显示轻度蛋白尿和血尿，血清肌酐显著升高。肾活检显示为急性毛细血管内增生性肾小球肾炎伴系膜IgM（免疫球蛋白M）沉积。全面检查未发现皮肤或关节疾病迹象，从而排除了过敏性紫癜。由于持续存在腹部不适，进一步进行了胃肠检查，最终从患者粪便中分离出空肠弯曲菌。在没有其他肾脏疾病诱发因素的情况下，我们推测细菌感染与这种感染后肾小球肾炎之间存在关联。在6个月的时间里，患者的肾功能完全恢复正常。然而，长期预后仍不明确。除了该病例报告外，我们还对文献进行了综述，结果强调了空肠弯曲菌引发各种免疫介导性肾脏疾病的可能性。
