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与耐甲氧西林金黄色葡萄球菌感染相关的新月体型 IgA 肾病的良好转归。

Favorable outcome of crescentic IgA nephropathy associated with methicillin-resistant Staphylococcus aureus infection.

机构信息

Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan, Republic of China.

出版信息

Ren Fail. 2011;33(1):96-100. doi: 10.3109/0886022X.2010.541576.

Abstract

Dominant or codominant IgA deposits in the setting of proliferative glomerulonephritis usually indicate IgA nephropathy, Henoch-Schönlein purpura nephritis, or, sometimes, lupus nephritis. However, a new type of poststaphylococcal glomerulonephritis with predominantly IgA deposition has been increasingly reported. Herein, we report an unusual case of rapidly progressive glomerulonephritis following methicillin-resistant Staphylococcus aureus infection. Renal biopsy showed crescentic IgA nephropathy. The renal function improved after eradication of infection and administration of immunosuppressive therapy. Although the limited data support the use of immunosuppressive agents in this setting, one must proceed with caution. We suggest that immunosuppressive therapy should only be an option if the underlying infection has definitely been well controlled while the renal disease still progresses.

摘要

在增生性肾小球肾炎中,IgA 呈优势或共显性沉积通常提示 IgA 肾病、过敏性紫癜性肾炎,有时也提示狼疮性肾炎。然而,越来越多的报道表明,存在一种新型的以 IgA 沉积为主的葡萄球菌感染后肾小球肾炎。本文报道了 1 例耐甲氧西林金黄色葡萄球菌感染后发生的快速进展性肾小球肾炎的不典型病例。肾脏活检显示新月体 IgA 肾病。在感染得到清除和免疫抑制治疗后,肾功能得到改善。尽管有限的数据支持在这种情况下使用免疫抑制剂,但必须谨慎。我们建议,只有在基础感染已得到有效控制而肾脏疾病仍在进展时,才应将免疫抑制治疗作为一种选择。

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