Bjerre Anna, Høgåsen Kolbjørn, Grøtta Jon, Scott Helge, Tangeraas Trine, Dörje Christina
Department of Pediatrics, Division for Specialised Medicine , Oslo University Hospital , Rikshospitalet, Oslo , Norway.
Department of Immunology and Transfusion Medicine , Sykehuset Innlandet Trust , Lillehammer , Norway.
Clin Kidney J. 2012 Dec;5(6):584-586. doi: 10.1093/ckj/sfs146.
Anti-glomerular basement membrane (anti-GBM) nephritis is rare in childhood with few published cases. We report a 19-month-old boy with rapidly progressive glomerulonephritis (RPGN) due to anti-GBM nephritis. Treatment was started under 2 weeks after presentation and included plasma exchange, intravenous high-dose methylprednisolone, intravenous cyclophosphamide and mycophenolate as mainstay medication. The treatment was rapidly effective with immediate decrease in anti-GBM titres and plasma creatinine. Three years after presentation, the boy has normal kidney function, blood pressure and no residual disease. The successful outcome was likely due to the rapid recognition of the anti-GBM antibodies as the cause of RPGN and aggressive primary treatment.
抗肾小球基底膜(anti-GBM)肾炎在儿童中较为罕见,已发表的病例很少。我们报告了一名19个月大的男孩,因抗GBM肾炎导致快速进展性肾小球肾炎(RPGN)。在出现症状后2周内开始治疗,主要治疗方法包括血浆置换、静脉注射大剂量甲基强的松龙、静脉注射环磷酰胺和霉酚酸酯。治疗迅速起效,抗GBM滴度和血浆肌酐立即下降。出现症状三年后,该男孩肾功能正常、血压正常且无残留疾病。成功的治疗结果可能得益于对抗GBM抗体作为RPGN病因的快速识别以及积极的初始治疗。