Iseri Ken, Iyoda Masayuki, Yamamoto Yasutaka, Kobayashi Naoto, Oda Takashi, Yamaguchi Yutaka, Shibata Takanori
Division of Nephrology, Department of Medicine, Showa University School of Medicine, Japan.
Intern Med. 2016;55(6):647-50. doi: 10.2169/internalmedicine.55.5409. Epub 2016 Mar 15.
We herein report the case of an 18-year-old boy who developed nephrotic syndrome and hypertension after upper airway inflammation. Post-streptococcal acute glomerulonephritis was diagnosed on the basis of a high antistreptolysin O titer, hypocomplementemia, proteinuria, and microscopic hematuria. A renal biopsy was performed due to persistent proteinuria, and the pathological diagnosis was membranoproliferative glomerulonephritis (MPGN) type I. Glomeruli showed positive staining for nephritis-associated plasmin receptor (NAPlr), a nephritogenic group A streptococcal antigen, and plasmin activity was found in a similar distribution as NAPlr deposition. This rare case of streptococcal infection-related nephritis (SIRN) manifesting MPGN type I supports the histological diversity of SIRN.
我们在此报告一例18岁男孩,其在上呼吸道炎症后出现肾病综合征和高血压。根据抗链球菌溶血素O滴度升高、补体血症、蛋白尿和镜下血尿诊断为链球菌感染后急性肾小球肾炎。由于持续性蛋白尿进行了肾活检,病理诊断为I型膜增生性肾小球肾炎(MPGN)。肾小球显示与肾炎相关纤溶酶受体(NAPlr)呈阳性染色,NAPlr是一种致肾炎的A组链球菌抗原,且纤溶酶活性的分布与NAPlr沉积相似。这例罕见的表现为I型MPGN的链球菌感染相关肾炎(SIRN)病例支持了SIRN的组织学多样性。