与慢性淋巴细胞白血病相关的IgG4相关性肾小管间质性肾炎。
IgG4-related tubulointerstitial nephritis associated with chronic lymphocytic leukemia.
作者信息
Malone Andrew F, Sparks Matthew A, Howell David N, Middleton John Paul, Smith Stephen R, Lehrich Ruediger W
机构信息
Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, NC - USA.
出版信息
J Nephrol. 2013 Nov-Dec;26(6):1195-8. doi: 10.5301/jn.5000298. Epub 2013 Nov 26.
BACKGROUND
Tubulointerstitial nephritis (TIN) is typically seen in association with drug exposure and infection or in autoimmune diseases such as Sjogren's syndrome or systemic lupus erythematosis. The recently described IgG4-related systemic diseases can affect many organ systems including the kidney and typically respond to corticosteroid treatment.
CASE
We present a case of IgG4-related TIN in a patient with concomitant chronic lymphocytic leukemia. To our knowledge, IgG4-related TIN has not been associated with any hematological disorder such as chronic lymphocytic leukemia.
CONCLUSION
We propose that all kidney biopsies with significant plasma cell infiltrate should be stained for IgG4 as response to treatment is common.
背景
肾小管间质性肾炎（TIN）通常与药物暴露、感染相关，或见于自身免疫性疾病，如干燥综合征或系统性红斑狼疮。最近描述的IgG4相关性全身性疾病可累及包括肾脏在内的多个器官系统，且通常对皮质类固醇治疗有反应。
病例
我们报告一例伴有慢性淋巴细胞白血病的患者发生IgG4相关性TIN。据我们所知，IgG4相关性TIN尚未与任何血液系统疾病如慢性淋巴细胞白血病相关联。
结论
我们建议，所有有显著浆细胞浸润的肾活检标本均应进行IgG4染色，因为对治疗有反应很常见。
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