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肾移植患者并发鼻咽部T细胞单形性移植后淋巴组织增生性疾病及IgA肾病合并膜性肾小球肾炎:一例报告并文献复习

Nasopharyngeal T-cell monomorphic posttransplant lymphoproliferative disorders and combined IgA nephropathy and membranous glomerulonephritis in a patient with renal transplantation: a case report with literature review.

作者信息

Kfoury H K, Alghonaim M, AlSuwaida A K, Zaidi S Naseem, Arafah M

机构信息

Department of Histopathology, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia.

出版信息

Transplant Proc. 2010 Dec;42(10):4653-7. doi: 10.1016/j.transproceed.2010.09.162.

Abstract

Recurrent and/or de novo glomerular diseases occurring in a renal allograft have been reported in the literature and are an important cause of graft dysfunction and eventual loss. The simultaneous occurrence of two glomerulonephritis, although reported in the literature, is a rare phenomenon. Posttransplant lymphoproliferative disorders (PTLD) are well known and one of the most serious and potentially fatal complications of chronic immunosuppression in the solid organ transplant recipient. Here, we are reporting the first case, to the best of our knowledge, of simultaneous occurrence of nasopharyngeal monomorphic monoclonal PTLD and two distinctive glomerular diseases (IgA nephropathy and membranous glomerulonephritis) in a 49-year-old patient who was 5 years post-renal transplantation. We have provided the clinical history of our patient who presented with nephrotic range proteinuria, microscopic hematuria, and a nasopharyngeal mass as well as a review of the literature.

摘要

肾移植后复发性和/或新发肾小球疾病在文献中已有报道,是移植肾功能障碍及最终移植肾丢失的重要原因。虽然文献中报道过同时发生两种肾小球肾炎的情况,但这是一种罕见现象。移植后淋巴细胞增生性疾病(PTLD)广为人知,是实体器官移植受者慢性免疫抑制最严重且潜在致命的并发症之一。在此,据我们所知,我们报告了首例肾移植术后五年的49岁患者同时发生鼻咽部单形性单克隆PTLD及两种不同的肾小球疾病(IgA肾病和膜性肾小球肾炎)的病例。我们提供了该患者出现肾病范围蛋白尿、镜下血尿和鼻咽部肿物的临床病史以及文献综述。

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