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伴有桥本甲状腺炎的肾肾小球疾病的共存表现。

Coexistent findings of renal glomerular disease with Hashimoto's thyroiditis.

机构信息

Department of Nephrology, Ankara Education and Research Hospital, Ankara, Turkey.

出版信息

Clin Endocrinol (Oxf). 2012 May;76(5):759-62. doi: 10.1111/j.1365-2265.2011.04302.x.

Abstract

AIM AND BACKGROUND

Hashimoto's thyroiditis (HT) is a common autoimmune thyroid disease with a female preponderance. Renal involvement in HT is not uncommon. In the present study, we aimed to define the frequency and characteristics of the glomerular diseases associated with HT and further the understanding of any common pathogenesis between HT and glomerular disease.

MATERIALS AND METHODS

We reviewed retrospectively 28 patients with HT who were referred to our Department because of unexplained haematuria, proteinuria or renal impairment from 2007 to 2011. Routine laboratory investigations including blood count, serum biochemistry, urinalysis and 24-h urinary protein excretion were performed on all patients. Renal biopsy was performed in 20 patients with HT, and the specimens were examined by light microscopy and immunofluorescence staining.

RESULTS

We detected four cases of focal segmental glomerulosclerosis (FSGS), four membranous glomerulonephritis (MGN), two minimal-change disease (MCD), three immunoglobulin A nephritis (IgAN), three chronic glomerulonephritis (CGN) and one amyloidosis. In three patients, the renal biopsy findings were nonspecific. Daily urinary protein excretion and glomerular filtration rates were found to be independent of the level of thyroid hormone and thyroid-specific autoantibodies.

CONCLUSION

Glomerular pathologies associated with HT are similar to those in the general population, the most common lesions being MGN, FSGS and IgA nephritis.

摘要

目的和背景

桥本甲状腺炎(HT)是一种常见的自身免疫性甲状腺疾病,女性患病率较高。HT 累及肾脏并不少见。本研究旨在确定与 HT 相关的肾小球疾病的频率和特征,并进一步了解 HT 和肾小球疾病之间的任何共同发病机制。

材料和方法

我们回顾性分析了 2007 年至 2011 年间因不明原因血尿、蛋白尿或肾功能损害而被转至我科的 28 例 HT 患者。对所有患者均进行了常规实验室检查,包括血常规、血清生化、尿液分析和 24 小时尿蛋白排泄量。对 20 例 HT 患者进行了肾活检,对标本进行了光镜和免疫荧光染色检查。

结果

我们发现 4 例局灶节段性肾小球硬化症(FSGS)、4 例膜性肾小球肾炎(MGN)、2 例微小病变性肾病(MCD)、3 例免疫球蛋白 A 肾病(IgAN)、3 例慢性肾小球肾炎(CGN)和 1 例淀粉样变性。在 3 例患者中,肾活检结果无特异性。每日尿蛋白排泄量和肾小球滤过率与甲状腺激素和甲状腺特异性自身抗体水平无关。

结论

与 HT 相关的肾小球病变与普通人群中的病变相似,最常见的病变为 MGN、FSGS 和 IgA 肾病。

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