Hirohama Daigoro, Hoshino Junichi, Sumida Keiichi, Hasegawa Eiko, Hiramatsu Rikako, Yamanouchi Masayuki, Hayami Noriko, Suwabe Tatsuya, Sawa Naoki, Takemoto Fumi, Ubara Yoshifumi, Hara Shigeko, Ohashi Kenichi, Takaichi Kenmei
Nephrology Center, Toranomon Hospital, Japan.
Intern Med. 2012;51(12):1555-60. doi: 10.2169/internalmedicine.51.6063. Epub 2012 Jun 15.
We encountered an unusual and rare case of 59-year-old woman with Churg-Strauss syndrome (CSS) showing myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA)-related acute renal insufficiency accompanied by eosinophilic tubulointerstitial nephritis. To date, reports in English of CSS presenting with rapidly progressive/acute renal insufficiency and biopsy-proven renal lesions have been uncommon. Here, we discuss this unusual case and review the previously reported CSS cases. The complication of eosinophilic tubulointerstitial nephritis in CSS cases with acute renal insufficiency might be higher than generally thought. Furthermore, the presence of eosinophilic infiltration and eosinophilic tubulointerstitial nephritis might be associated with the good renal outcome in CSS patients.
我们遇到了一例不同寻常且罕见的病例,一名59岁女性患有Churg-Strauss综合征(CSS),表现为髓过氧化物酶抗中性粒细胞胞浆抗体(MPO-ANCA)相关的急性肾功能不全,并伴有嗜酸性小管间质性肾炎。迄今为止,英文报道中CSS伴有快速进展性/急性肾功能不全且经活检证实有肾脏病变的情况并不常见。在此,我们讨论这一罕见病例并回顾先前报道的CSS病例。CSS合并急性肾功能不全病例中嗜酸性小管间质性肾炎的并发症可能比一般认为的更高。此外,嗜酸性浸润和嗜酸性小管间质性肾炎的存在可能与CSS患者良好的肾脏预后相关。