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表现为I型膜增生性肾小球肾炎的链球菌感染相关性肾炎(SIRN)

Streptococcal Infection-related Nephritis (SIRN) Manifesting Membranoproliferative Glomerulonephritis Type I.

作者信息

Iseri Ken, Iyoda Masayuki, Yamamoto Yasutaka, Kobayashi Naoto, Oda Takashi, Yamaguchi Yutaka, Shibata Takanori

机构信息

Division of Nephrology, Department of Medicine, Showa University School of Medicine, Japan.

出版信息

Intern Med. 2016;55(6):647-50. doi: 10.2169/internalmedicine.55.5409. Epub 2016 Mar 15.

Abstract

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.

摘要

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。

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