Wągrowska-Danilewicz M, Danilewicz M, Zbrog Z
Małgorzata ągrowska-Danilewicz, Department of Nephropathology, Medical University of Lodz, Pomorska 251, 92-216 Lodz, Poland, e-mail:
Pol J Pathol. 2014 Dec;65(4):322-6. doi: 10.5114/pjp.2014.48194.
A 42-year-old man was admitted to the Nephrology Department because of nephrotic syndrome. Eight months prior to admission he attempted suicide by intravenous self-injection of 2.5 ml of elemental mercury. Renal biopsy was performed. Light microscopy findings showed normal glomeruli and injury of proximal tubular cells. Immunofluorescence was negative, and electron microscopy study revealed diffuse effacement of podocyte foot processes and vacuolization of podocyte cytoplasm. Minimal change disease was diagnosed. The patient was treated with 2,3-dimercaptopropane-1-sulfonate, for mercury detoxification, and steroids. In one-year follow-up the 24-h urine protein excretion decreased from 30 γ to 0.186 g, and the renal function remain normal. The presented case indicates that mercury intoxication should be mentioned as a cause of secondary minimal change disease.
一名42岁男性因肾病综合征入住肾内科。入院前8个月，他试图通过静脉自注2.5毫升元素汞自杀。进行了肾活检。光镜检查结果显示肾小球正常，近端肾小管细胞受损。免疫荧光检查为阴性，电镜研究显示足细胞足突弥漫性消失和足细胞胞质空泡化。诊断为微小病变病。患者接受了2,3-二巯基丙烷-1-磺酸盐进行汞解毒治疗以及类固醇治疗。在一年的随访中，24小时尿蛋白排泄量从30γ降至0.186克，肾功能保持正常。该病例表明汞中毒应被视为继发性微小病变病的一个病因。
