Vega Jorge, Díaz Rienzi, Méndez Gonzalo R, Goecke Helmuth
Sección de Nefrología, Servicio de Medicina, Hospital Naval Almirante Nef, Viña del Mar, Chile.
Rev Med Chil. 2013 Mar;141(3):381-7. doi: 10.4067/S0034-98872013000300015.
Celiac disease may be associated with other autoimmune diseases and exceptionally with glomerulopathies and nephrotic syndrome. Associations have been reported with IgA nephropathy, membranoproliferative glomerulonephritis, membranous glomerulopathy and minimal change disease. We report a 63-year-old woman who simultaneously presented with massive nephrotic syndrome (proteinuria 46 g/day) and cachexia due to a malabsorption syndrome secondary to celiac disease. The course of her diseases was complicated with cardiomyopathy due to severe malnutrition, septic shock, acute kidney injury that required dialysis for seven weeks and severe hypertension. A renal biopsy showed a membranoproliferative pattern of injury secondary to a thrombotic microangiopathy and diffuse podocyte damage. Four years later, the patient was in good general health, the glomerular filtration rate was 30 ml/min/1.73m² and there was non-nephrotic proteinuria.
乳糜泻可能与其他自身免疫性疾病相关,极少数情况下与肾小球病和肾病综合征有关。已有报道其与IgA肾病、膜增生性肾小球肾炎、膜性肾小球病和微小病变病有关。我们报告一名63岁女性,她同时患有大量蛋白尿(46克/天)的肾病综合征和因乳糜泻继发的吸收不良综合征导致的恶病质。她的病程因严重营养不良并发心肌病、感染性休克、需要透析7周的急性肾损伤和严重高血压而复杂化。肾活检显示血栓性微血管病继发的膜增生性损伤模式和弥漫性足细胞损伤。四年后,患者总体健康状况良好,肾小球滤过率为30毫升/分钟/1.73平方米,存在非肾病性蛋白尿。