Takeshima Eri, Morishita Yoshiyuki, Ogura Manabu, Ito Chiharu, Saito Osamu, Takemoto Fumi, Ando Yasuhiro, Muto Shigeaki, Yumura Wako, Kusano Eiji
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke-shi, Japan.
Case Rep Nephrol Urol. 2012 Jul;2(2):158-64. doi: 10.1159/000345280. Epub 2012 Nov 15.
A 70-year-old man complained of muscle pain in his neck, shoulders and pelvic girdle. Proteinuria and hematuria subsequently developed. Blood analysis showed increased acute phase reactants. The histology of renal biopsy showed diffuse endocapillary proliferative glomerulonephritis. There were no signs of autoimmune diseases, malignancies and bacterial or viral infections. His extrarenal symptoms and the results of blood analysis fulfilled three different criteria of polymyalgia rheumatica (PMR). Therefore, diffuse endocapillary proliferative glomerulonephritis associated with PMR was diagnosed. After low-dose prednisolone (10 mg/day) treatment, the muscle pain disappeared, acute phase reactants decreased and hematuria and proteinuria improved. The renal complication of PMR is rare but important to be considered early in the right clinical context.
一名70岁男性主诉颈部、肩部和骨盆带肌肉疼痛。随后出现蛋白尿和血尿。血液分析显示急性期反应物增加。肾活检组织学显示弥漫性毛细血管内增生性肾小球肾炎。无自身免疫性疾病、恶性肿瘤及细菌或病毒感染迹象。他的肾外症状和血液分析结果符合风湿性多肌痛(PMR)的三种不同标准。因此,诊断为与PMR相关的弥漫性毛细血管内增生性肾小球肾炎。经低剂量泼尼松龙(10毫克/天)治疗后,肌肉疼痛消失,急性期反应物减少,血尿和蛋白尿改善。PMR的肾脏并发症罕见,但在正确的临床背景下早期考虑很重要。