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特发性膜性肾病并发罕见的毛霉菌病后肾病综合征戏剧性缓解

Dramatic remission of nephrotic syndrome after unusual complication of mucormycosis in idiopathic membranous nephropathy.

作者信息

Ye Wenling, Wang Yingyi, Wen Yubing, Li Hang, Li Xuemei

机构信息

Division of Nephrology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Shuifuyuan 1, Wangfujing, Beijing, 100730, China,

出版信息

Int Urol Nephrol. 2014 Jun;46(6):1247-51. doi: 10.1007/s11255-013-0628-3. Epub 2014 Jan 11.

Abstract

Mucormycosis is a rare and fatal opportunistic infection occurring in severely immunocompromised patients. Here, we report, for the first time, on a 65-year-old man with idiopathic membranous nephropathy and moderate renal dysfunction who suffered from life-threatening pulmonary mucormycosis during immunosuppressive therapy. After amphotericin B (AmB) administration with a total accumulating dose of 1.5 g, not only has he recovered from this fatal infection, but also his nephrotic syndrome has entered complete and long-term remission without any continued corticosteroid and immunosuppressive therapy during the 6-year follow-up. Serum creatinine levels remained stable by adjusting the tolerable daily dose of AmB during the period of treatment.

摘要

毛霉病是一种发生在严重免疫功能低下患者中的罕见且致命的机会性感染。在此,我们首次报告一名65岁患有特发性膜性肾病和中度肾功能不全的男性,在免疫抑制治疗期间患上危及生命的肺部毛霉病。在给予两性霉素B(AmB)累计总剂量达1.5 g后,他不仅从这种致命感染中康复,而且在6年随访期间,其肾病综合征在未继续使用任何糖皮质激素和免疫抑制治疗的情况下进入完全且长期缓解状态。在治疗期间,通过调整AmB的每日耐受剂量,血清肌酐水平保持稳定。

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