Miki Takuya, Akimoto Tetsu, Sugase Taro, Numata Akihiko, Otani Naoko, Iwazu Yoshitaka, Takeshima Eri, Morishita Yoshiyuki, Muto Shigeaki, Kusano Eiji
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan.
Intern Med. 2012;51(24):3395-9. doi: 10.2169/internalmedicine.51.8507. Epub 2012 Dec 15.
Rapidly progressive glomerulonephritis (RPGN) is characterized by the rapid deterioration of the renal function associated with crescent formation on renal biopsies. This report describes a case of RPGN caused by anti-glomerular basement membrane (GBM) glomerulonephritis in an elderly man with severe thrombocytopenia and a platelet count of 1.4 × 10(4)/µL. Thrombotic microangiopathy (TMA) and heparin-induced thrombocytopenia (HIT) were implicated in the severe decrease in platelets. This report also discusses the pathological background and clinical management of TMA and HIT among patients with anti-GBM glomerulonephritis.
急进性肾小球肾炎(RPGN)的特征是肾功能迅速恶化,并伴有肾活检时新月体形成。本报告描述了一例由抗肾小球基底膜(GBM)肾小球肾炎引起的RPGN病例,患者为老年男性,伴有严重血小板减少,血小板计数为1.4×10⁴/µL。血栓性微血管病(TMA)和肝素诱导的血小板减少症(HIT)被认为与血小板严重减少有关。本报告还讨论了抗GBM肾小球肾炎患者中TMA和HIT的病理背景及临床处理。