Nanno Satoru, Nakamae Hirohisa, Kuwamura Yukinobu, Ishimura Eiji, Sakabe Manami, Inaba Akiko, Koh Shiro, Yoshimura Takuro, Nishimoto Mitsutaka, Hayashi Yoshiki, Terada Yoshiki, Nakane Takahiko, Koh Hideo, Nakao Yoshitaka, Ohsawa Masahiko, Hino Masayuki
Hematology, Graduate School of Medicine, Osaka City University.
Rinsho Ketsueki. 2013 Jul;54(7):658-63.
A 30-year-old female developed fever and multiple lymphadenopathy in September 2011. Her symptoms improved with antibiotic treatment. However, she again presented with fever and multiple lymphadenopathy in December 2011. In addition, she suffered from nephrotic syndrome with severe edema. She was therefore hospitalized to undergo detailed examinations. Renal biopsy revealed endocapillary proliferative glomerulonephritis. Since her renal function deteriorated rapidly, she was given steroid pulse therapy with methylprednisolone, followed by maintenance therapy with prednisolone. After treatment, her renal function improved but multiple lymphadenopathy persisted. Biopsy of a left axillary lymph node was then performed and revealed angioimmunoblastic T-cell lymphoma (AITL). She received CHOP therapy but showed no response. Therefore, she was given ESHAP therapy. A partial response was achieved and the nephrotic syndrome also resolved completely. We report this extremely rare case of renal dysfunction due to endocapillary proliferative glomerulonephritis complicated by AITL.
一名30岁女性于2011年9月出现发热和多处淋巴结病。经抗生素治疗后症状改善。然而，她在2011年12月再次出现发热和多处淋巴结病。此外，她患有肾病综合征并伴有严重水肿。因此，她住院接受详细检查。肾活检显示毛细血管内增生性肾小球肾炎。由于她的肾功能迅速恶化，给予甲泼尼龙进行类固醇冲击治疗，随后用泼尼松进行维持治疗。治疗后，她的肾功能有所改善，但多处淋巴结病仍持续存在。随后对左侧腋窝淋巴结进行活检，结果显示为血管免疫母细胞性T细胞淋巴瘤（AITL）。她接受了CHOP方案治疗，但无反应。因此，给予她ESHAP方案治疗。获得了部分缓解，肾病综合征也完全缓解。我们报告了这例极为罕见的因毛细血管内增生性肾小球肾炎并发AITL导致肾功能障碍的病例。
