Miki Atsushi, Takeda Shin-Ichi, Isoda Norio, Yamamoto Hisashi, Okada Mari, Nakagawa Saki, Imai Toshimi, Sato Ryuta, Saito Osamu, Nagata Daisuke
Division of Nephrology, Department of Medicine, Jichi Medical University, Japan.
Intern Med. 2015;54(15):1885-9. doi: 10.2169/internalmedicine.54.3634. Epub 2015 Aug 1.
Acute poststreptococcal glomerulonephritis (APSGN) is a well-established disease. Although various immune responses are thought to be involved in the pathogenesis of APSGN, the disease has a self-limiting nature in clinical practice, despite the presence of severe acute symptoms. We herein report the case of a 78-year-old woman with APSGN who developed primary biliary cirrhosis (PBC) after achieving remission of renal manifestations, including anasarca and elevation of serum creatinine, indicating that persistent alterations in the immune system can cause extrarenal disorders. This case provides insights into the appropriate clinical management of ASPGN and pathogenesis of PBC.
急性链球菌感染后肾小球肾炎(APSGN)是一种已明确的疾病。尽管多种免疫反应被认为参与了APSGN的发病机制,但在临床实践中,尽管存在严重的急性症状,该疾病仍具有自限性。我们在此报告一例78岁患有APSGN的女性病例,该患者在包括全身性水肿和血清肌酐升高在内的肾脏表现缓解后发生了原发性胆汁性肝硬化(PBC),这表明免疫系统的持续改变可导致肾外疾病。该病例为APSGN的适当临床管理及PBC的发病机制提供了见解。