Kato A, Hishida A, Kimura M, Yoneyama T, Arai T, Honda N
First Department of Medicine, Hamamatsu University School of Medicine, Japan.
Jpn J Med. 1990 May-Jun;29(3):292-5. doi: 10.2169/internalmedicine1962.29.292.
Recurrence of anti-glomerular membrane antibody glomerulonephritis seems to be an unusual clinical phenomenon. We report a 57-year-old man with recurrence of anti-glomerular basement membrane antibody glomerulonephritis. He developed a rapidly progressive glomerulonephritis with anti-glomerular basement membrane antibody (anti-GBM Ab), and recovered with a combined treatment of prednisolone, anticoagulant and antiplatelet agents. After a 2-year remission, hematuria and proteinuria followed by renal functional deterioration occurred without any obvious cause. The second renal biopsy revealed cellular crescents with linear IgG deposition along GBM, a finding similar to the first one. The aforementioned combined treatment resulted in a gradual recovery from proteinuria and renal functional derangement.
抗肾小球基底膜抗体肾小球肾炎复发似乎是一种不常见的临床现象。我们报告一例57岁抗肾小球基底膜抗体肾小球肾炎复发的男性患者。他患了伴有抗肾小球基底膜抗体(抗GBM抗体)的快速进展性肾小球肾炎,并通过泼尼松龙、抗凝剂和抗血小板药物联合治疗得以康复。在缓解2年后,无明显诱因出现血尿、蛋白尿,随后肾功能恶化。第二次肾活检显示有细胞性新月体形成,沿肾小球基底膜有线性IgG沉积,这一发现与第一次相似。上述联合治疗使蛋白尿和肾功能紊乱逐渐恢复。