一例同时合并髓过氧化物酶/蛋白酶3阴性抗中性粒细胞胞浆抗体相关性肾小球肾炎和膜性肾小球病的病例。
A Case of Concurrent MPO-/PR3-Negative ANCA-Associated Glomerulonephritis and Membranous Glomerulopathy.
作者信息
Nakada Yasuyuki, Tsuboi Nobuo, Takahashi Yasuto, Yoshida Hiraku, Hara Yoriko, Okonogi Hideo, Kawamura Tetsuya, Arimura Yoshihiro, Yokoo Takashi
机构信息
Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo 105-8461, Japan.
Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan.
出版信息
Case Rep Nephrol. 2015;2015:316863. doi: 10.1155/2015/316863. Epub 2015 Jan 8.
We report a case in which antineutrophil cytoplasmic antibody- (ANCA-) associated glomerulonephritis and membranous glomerulopathy (MGN) were detected concurrently. The patient showed rapidly progressive renal deterioration. A renal biopsy showed crescentic glomerulonephritis, together with marked thickening and spike and bubbling formations in the glomerular basement membranes. Indirect immunofluorescence examination of the patient's neutrophils showed a perinuclear pattern. Enzyme-linked immunosorbent assays revealed that the ANCA in this case did not target myeloperoxidase (MPO) or proteinase 3 (PR3) but bactericidal-/permeability-increasing protein, elastase, and lysosome. The relationship between these two etiologically distinct entities, MPO-/PR3-negative ANCA-associated glomerulonephritis and MGN, remains unclear.
我们报告了一例同时检测出抗中性粒细胞胞浆抗体（ANCA）相关性肾小球肾炎和膜性肾小球病（MGN）的病例。该患者出现快速进展性肾功能恶化。肾活检显示新月体性肾小球肾炎，同时肾小球基底膜有明显增厚及钉突和小泡形成。对患者中性粒细胞进行间接免疫荧光检查显示核周型。酶联免疫吸附试验表明，该病例中的ANCA不靶向髓过氧化物酶（MPO）或蛋白酶3（PR3），而是靶向杀菌/通透性增加蛋白、弹性蛋白酶和溶酶体。这两种病因不同的疾病实体，即MPO/PR3阴性ANCA相关性肾小球肾炎和MGN之间的关系仍不清楚。
Zotero 插件