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肾移植后肾小球抗基底膜抗体所致肾小球肾炎

[Glomerulonephritis by glomerular anti-basement membrane antibodies after renal transplantation].

作者信息

Noel L H, Bobrie G, Pochet J M, Pirson Y, Goldman M, Moulonguet-Doleris L, Farge D, Déchelette E, Grunfeld J P

机构信息

Département de Néphrologie, Hôpital Necker, Paris.

出版信息

Nephrologie. 1989;10(3):113-5.

PMID:2691906
Abstract

Glomerulonephritis (GN) due to antiglomerular basement membrane (GBM) antibodies after kidney transplantation may be classified into two groups: 1. Recurrent GN are very rare provided circulating anti-GBM antibodies are absent at grafting. If present, linear fixation along the GBM occurs but does not lead to GN in some cases. 2. De novo anti-GBM diseases have been rarely reported. They developed in 8 patients with Alport's syndrome and in at least 3 additional patients in whom hereditary nephritis was not the original disease. A prospective and retrospective study was performed in 54 transplanted patients with hereditary nephritis: circulating anti-GBM antibodies were detected in only one case; linear fixation along the GBM was found but no evidence of GN. The risk of anti-GBM disease after kidney transplantation is low in patients with hereditary nephritis but this complication must be rapidly identified. Its occurrence is probably related to the defect in GBM antigenicity involving the Goodpasture antigen, found in some patients with Alport's syndrome or related hereditary nephritis.

摘要

肾移植后由抗肾小球基底膜(GBM)抗体引起的肾小球肾炎(GN)可分为两组:1. 复发性GN非常罕见,前提是移植时不存在循环抗GBM抗体。如果存在,沿GBM会出现线性沉积,但在某些情况下不会导致GN。2. 新发抗GBM疾病鲜有报道。在8例Alport综合征患者以及至少3例原发病并非遗传性肾炎的患者中出现了这种疾病。对54例遗传性肾炎移植患者进行了一项前瞻性和回顾性研究:仅在1例患者中检测到循环抗GBM抗体;发现沿GBM有线性沉积,但无GN证据。遗传性肾炎患者肾移植后发生抗GBM疾病的风险较低,但必须迅速识别这种并发症。其发生可能与某些Alport综合征或相关遗传性肾炎患者中发现的涉及Goodpasture抗原的GBM抗原性缺陷有关。

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