Komada Takanori, Morishita Yoshiyuki, Kitamura Masafumi, Iwazu Kana, Numata Akihiko, Kobayashi Takahisa, Yamamoto Hisashi, Akimoto Tetsu, Saito Osamu, Ando Yasuhiro, Takemoto Fumi, Muto Shigeaki, Yumura Wako, Kusano Eiji
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan.
Intern Med. 2013;52(12):1383-7. doi: 10.2169/internalmedicine.52.0094.
We herein report the case of a 75-year-old man who developed an increased serum creatinine level (4.93 mg/dL) and oliguria with massive proteinuria (7.14 g/day) on the second day after a single oral administration of high-dose (56 mg) minodronate. The histology of a renal biopsy showed one area of glomerular sclerosis among 20 glomeruli with global foot process effacement of podocytes and mild infiltration of lymphocytes and eosinophils into the interstitial space. Acute kidney injury in nephrotic syndrome due to focal segmental glomerular sclerosis induced by minodronate was diagnosed. Following cessation of minodronate without the administration of immunosuppressive agents, the patient's renal function and proteinuria markedly improved.
我们在此报告一例75岁男性病例,该患者在单次口服高剂量(56mg)米诺膦酸后第二天,血清肌酐水平升高(4.93mg/dL),出现少尿并伴有大量蛋白尿(7.14g/天)。肾活检组织学检查显示,20个肾小球中有一个区域出现肾小球硬化,足细胞足突广泛消失,间质有轻度淋巴细胞和嗜酸性粒细胞浸润。诊断为米诺膦酸诱导的局灶节段性肾小球硬化所致肾病综合征急性肾损伤。在停用米诺膦酸且未使用免疫抑制剂后,患者的肾功能和蛋白尿明显改善。