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干扰素-β治疗期间出现肾病范围蛋白尿：免疫诱导的肾小球肾炎还是其他途径？

Nephrotic-range proteinuria on interferon-β treatment: immune-induced glomerulonephritis or other pathway?

作者信息

Yuste C, Rapalai M, Pritchard B A, Jones T J, Tucker B, Ramakrishna S B

机构信息

Shrewsbury and Telford NHS Trust , Shorpshire, UK.

King's College Hospital , London, UK.

出版信息

Clin Kidney J. 2014 Apr;7(2):190-3. doi: 10.1093/ckj/sfu016. Epub 2014 Mar 9.

DOI:10.1093/ckj/sfu016
PMID:25852870
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4377790/
Abstract

We present a case report of a 37-year-old woman with multiple sclerosis (MS) who developed nephrotic-range proteinuria secondary to membrano proliferative glomerulonephritis (MPGN)-like disease with mesangial C3 deposition without evidence of immune-complex deposition in the context of long-term interferon-β (IFN-β) therapy. The complete remission of proteinuria following cessation of IFN-β, strongly suggests causality. To our knowledge, this is the second case report of MPGN associated with IFN-β use. This being the case, the negative immune screen, normal inflammatory markers and the absence of immune complex deposits would imply a different pathway to that previously suggested.

摘要

我们报告一例37岁的多发性硬化症（MS）女性患者，在长期使用干扰素-β（IFN-β）治疗期间，继发膜增生性肾小球肾炎（MPGN）样疾病伴系膜C3沉积，出现肾病范围蛋白尿，且无免疫复合物沉积证据。停用IFN-β后蛋白尿完全缓解，强烈提示存在因果关系。据我们所知，这是第二例与使用IFN-β相关的MPGN病例报告。既然如此，免疫筛查阴性、炎症标志物正常以及无免疫复合物沉积意味着其发病途径与之前提出的不同。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c7b/4377790/a56711263ec2/sfu01602.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c7b/4377790/4aaa585c4d76/sfu01601.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c7b/4377790/a56711263ec2/sfu01602.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c7b/4377790/4aaa585c4d76/sfu01601.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c7b/4377790/a56711263ec2/sfu01602.jpg

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Nephrotic syndrome in a multiple sclerosis patient receiving long-term interferon beta therapy.多发性硬化症患者接受长期干扰素 β 治疗后发生肾病综合征。
Am J Kidney Dis. 2013 May;61(5):786-9. doi: 10.1053/j.ajkd.2012.11.049. Epub 2013 Feb 1.
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Membranoproliferative glomerulonephritis--a new look at an old entity.
膜增生性肾小球肾炎——对一个旧有疾病的新认识。
N Engl J Med. 2012 Mar 22;366(12):1119-31. doi: 10.1056/NEJMra1108178.
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Membranoproliferative glomerulonephritis: pathogenetic heterogeneity and proposal for a new classification.膜增生性肾小球肾炎：发病机制的异质性和新分类的建议。
Semin Nephrol. 2011 Jul;31(4):341-8. doi: 10.1016/j.semnephrol.2011.06.005.
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Drug-induced systemic lupus erythematosus in interferon beta-1b therapy.干扰素β-1b治疗中药物诱导的系统性红斑狼疮
Neuro Endocrinol Lett. 2011;32(1):4-6.
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