肾小管间质性狼疮性肾炎
Tubulointerstitial lupus nephritis.
作者信息
Ali Ala, Al-Windawi Souad
机构信息
Renal Unit, Baghdad Teaching Hospital, Baghdad , Iraq.
Baghdad University, College of Medicine, Baghdad, Iraq.
出版信息
J Nephropathol. 2013 Jan;2(1):75-80. doi: 10.5812/nephropathol.9000. Epub 2013 Jan 1.
BACKGROUND
Isolated or predominant tubulointerstitial lupus nephritis is rare.
CASE PRESENTATION
Here we report the case of a thirty eight years old male who was diagnosed with systemic lupus erythematosus (SLE) according to clinical and laboratory criteria and presented with impaired renal function and non nephrotic range proteinuria. Renal biopsy revealed normal glomeruli but interstitial momonuclear cell infiltration. Immunohiostochemistry (IHC) showed immune deposits in the tubular basement membranes (TBMs), and the peritubular capillary basement membranes (PTCBMs). He was started on high dose oral steroids, which were gradually tapered over one month. His renal functions improved over few days and normalized by the end of the first month of treatment. He was continued on low dose steroids and azathioprine with no evidence of relapse.
CONCLUSIONS
Predominant tubulointerstitial lupus can occur, although rarely; and it runs a favorable course with good response to treatment.
背景
孤立性或主要为肾小管间质的狼疮性肾炎较为罕见。
病例报告
在此我们报告一例38岁男性病例，该患者根据临床和实验室标准被诊断为系统性红斑狼疮（SLE），并出现肾功能损害和非肾病范围蛋白尿。肾活检显示肾小球正常，但间质单核细胞浸润。免疫组织化学（IHC）显示在肾小管基底膜（TBMs）和肾小管周围毛细血管基底膜（PTCBMs）中有免疫沉积物。他开始接受大剂量口服类固醇治疗，在一个月内逐渐减量。他的肾功能在几天内有所改善，并在治疗的第一个月末恢复正常。他继续接受低剂量类固醇和硫唑嘌呤治疗，无复发迹象。
结论
主要为肾小管间质的狼疮虽罕见但可发生，且病程良好，对治疗反应良好。
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