Caijo Y, Almange C, Boutin J, Leblay R, Guerin D
Sem Hop. 1979;55(27-30):1271-4.
In 26 cases of myelofibrosis, the authors investigated for possible renal impairment that can be appraised from the usual clinical, laboratory, and roentgenographic signs. No anomalies were demonstrated in 12 of these cases. In 14 (or 53%) of the patients, some anomaly was discovered : essentially proteinuria with minor alteration of renal function, but also, two cases of poorly functioning left kidney evidenced on intravenous urograms, one case of acute anuric renal failure connected with hyperuricemia, one case of hypokalemic tubulo-interstitial nephritis, and one case of glomerulonephritis with, nephrotic syndrome. This study, when compared to the literature, indicates that besides nephropathy specific to myelofibrosis and attributed to myeloid metaplasia in the kidney, serious consideration must be given to lesions due to (1) compression of the left kidney by the enlarged spleen, (2) urate precipitation in the urinary passages, and (3) a possible glomerular disorder whose mechanism remains undefined.
在26例骨髓纤维化患者中,作者对可能存在的肾功能损害进行了研究,这些损害可通过常规临床、实验室及X线检查体征进行评估。其中12例未发现异常。在14例(占53%)患者中发现了一些异常情况:主要是蛋白尿伴轻度肾功能改变,此外,静脉肾盂造影显示2例左肾功能不良,1例与高尿酸血症相关的急性无尿性肾衰竭,1例低钾性肾小管间质性肾炎,以及1例伴有肾病综合征的肾小球肾炎。与文献相比,该研究表明,除了骨髓纤维化特有的、归因于肾脏髓外化生的肾病外,还必须认真考虑以下原因导致的病变:(1)肿大的脾脏对左肾的压迫;(2)尿路中尿酸盐沉淀;(3)机制尚不清楚的可能的肾小球疾病。