Kaneko Tomohiro, Mii Akiko, Fukui Megumi, Nagahama Kiyotaka, Shimizu Akira, Tsuruoka Shuichi
Division of Nephrology, Department of Internal Medicine, Nippon Medical School, Japan.
Intern Med. 2015;54(9):1085-90. doi: 10.2169/internalmedicine.54.3510. Epub 2015 May 1.
A 65-year-old man was admitted to our hospital with edema and renal dysfunction. He had received a diagnosis of psoriatic arthritis at 50 years of age. As a renal biopsy showed IgA nephropathy (IgAN), bilateral tonsillectomy was performed, and one course of steroid pulse therapy with an oral steroid and mizoribine were subsequently administered. The patient's proteinuria gradually reduced in association with an improvement in the renal function. In addition, the rash and arthralgia were ameliorated. In this case, adding treatment for chronic epipharyngitis accelerated the curative effects, and focal infection therapy consisting of immunosuppressive drugs was effective for both IgAN and psoriatic arthritis.
一名65岁男性因水肿和肾功能不全入院。他在50岁时被诊断为银屑病关节炎。由于肾活检显示为IgA肾病(IgAN),遂进行了双侧扁桃体切除术,随后给予一个疗程的类固醇冲击治疗以及口服类固醇和咪唑立宾。患者的蛋白尿随着肾功能的改善而逐渐减少。此外,皮疹和关节痛也有所改善。在该病例中,增加对慢性咽炎的治疗加速了疗效,由免疫抑制药物组成的病灶感染疗法对IgAN和银屑病关节炎均有效。