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一名感染人类免疫缺陷病毒(HIV)的患者出现狼疮样肾小球肾炎,伴有肾病范围蛋白尿、紫癜和IgA水平升高。

A case of lupus-like glomerulonephritis in an HIV patient with nephrotic range proteinuria, purpura, and elevated IgA level.

作者信息

Yang Jihyun, Seo Min Young, Kim Ki Tae, Lee Jun Yong, Kim Sun-Chul, Kim Myung-Gyu, Jo Sang-Kyung, Cho Won-Yong, Kim Hyoung-Kyu, Won Nam Hee, Cha Ran-Hui, Cho Eunjung

机构信息

Department of Internal Medicine, Division of Nephrology, National Medical Center Seoul, Korea.

Department of Pathology, Korea University Anam Hospital, National Medical Center Seoul, Korea.

出版信息

Int J Clin Exp Pathol. 2014 Jun 15;7(7):4467-72. eCollection 2014.

Abstract

Human immunodeficiency virus (HIV) infection is growing medical concern worldwide. There are many types of glomerulonephritis which are associated with HIV infection. We report a case of a 53-year-old Korean man with an HIV infection, who was developed nephritic range proteinuria and purpura with elevated IgA level rasing a possibility of Henoch-Schölein Purpura (H-S purpura). However, renal biopsy showed "lupus-like feature" glomerulonephritis without clinical or serologic evidence of systemic lupus erythematosus. Although baseline renal function was maintained without further need for maintenance dialysis following anti-retroviral therapy (ART) and steroid, patient died from uncontrolled gastrointestinal bleeding.

摘要

人类免疫缺陷病毒(HIV)感染在全球范围内日益引起医学关注。有多种类型的肾小球肾炎与HIV感染相关。我们报告一例53岁的韩国男性HIV感染者,其出现了肾病范围的蛋白尿和紫癜,IgA水平升高,提示可能为过敏性紫癜(H-S紫癜)。然而,肾活检显示为“狼疮样特征”的肾小球肾炎,而无系统性红斑狼疮的临床或血清学证据。尽管在抗逆转录病毒治疗(ART)和使用类固醇后,患者的基线肾功能得以维持,无需进一步进行维持性透析,但患者最终死于无法控制的胃肠道出血。

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