Dahan Karine, Albert Catherine, Arlet Jean-Benoît, Callard Patrice, Ronco Pierre
AP-HP, Hôpital Tenon , Service de Néphrologie et Dialyses, F-75020, Paris , France.
AP-HP, Hôpital Tenon , Service de Néphrologie et Dialyses, F-75020, Paris , France ; Hôpital de Chartres , Service de Néphrologie, Chartres , France.
NDT Plus. 2010 Dec;3(6):558-63. doi: 10.1093/ndtplus/sfq147. Epub 2010 Sep 1.
Renal involvement is frequent in patients suffering from primary Sjögren's syndrome (pSS). Tubulointerstitial infiltration is the most common renal lesion, while glomerular involvement is rare. We report the case of a 50-year-old woman with pSS who developed renal failure due to an unusual proliferative glomerulonephritis with humps and monotypic IgG1-kappa deposits. Searches for cryoglobulinaemia, anti-double-stranded DNA and anti-neutrophil cytoplasmic antibodies were negative. Serum protein electrophoresis and immunofixation revealed no monoclonal immunoglobulin. Extensive work-up excluded associated infectious, collagen or lymphoproliferative disease. This case adds to the spectrum of pSS-related glomerular disease which is reviewed in depth.
原发性干燥综合征(pSS)患者常出现肾脏受累。肾小管间质浸润是最常见的肾脏病变,而肾小球受累则较为罕见。我们报告了一例50岁的pSS女性患者,该患者因一种不寻常的伴有驼峰状病变和单型IgG1-κ沉积的增殖性肾小球肾炎而发展为肾衰竭。对冷球蛋白血症、抗双链DNA和抗中性粒细胞胞浆抗体的检测均为阴性。血清蛋白电泳和免疫固定电泳未发现单克隆免疫球蛋白。全面检查排除了相关的感染性、胶原性或淋巴增殖性疾病。本文深入回顾了该病例,进一步丰富了与pSS相关的肾小球疾病谱。