混合性冷球蛋白血症相关的干燥综合征导致肾脏自发性破裂：一例报告

Mixed cryoglobulinemia-associated Sjögren's syndrome leading to spontaneous rupture of the kidney: a case report.

作者信息

Haddiya Intissar, Hamzaoui Hakim, Alhamany Zitouna, Berkchi Fatime-Zohra, Rhou Hakima, Benamar Loubna, Ouzeddoun Naima, Bayahia Rabea

机构信息

Department of Nephrology-Dialysis-Renal Transplantation, Ibn Sina University Hospital, Rabat, Morocco.

Department of Pathology, Rabat Children's Hospital, Ibn Sina University Hospital, Rabat, Morocco.

出版信息

Int Med Case Rep J. 2016 Mar 23;9:77-81. doi: 10.2147/IMCRJ.S64262. eCollection 2016.

DOI:10.2147/IMCRJ.S64262

PMID:27042145

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4809340/

Abstract

BACKGROUND

Spontaneous rupture of the kidney is uncommon and is mainly caused by renal tumors. Only a few cases are caused by vasculitis. We report here the first case of spontaneous rupture of kidney resulting from mixed cryoglobulinemia.

CASE PRESENTATION

A 44-year-old man presented with sudden onset of fever, acute pulmonary edema, left flank abdominal pain unassociated with trauma, and rapidly progressive renal failure requiring dialysis. Computed tomography of the abdomen revealed a large perirenal hematoma of the left kidney. During conservative surgery, the patient underwent renal biopsy that showed renal vasculitis and membranoproliferative glomerulonephritis with intracapillary microthrombi. Tests were positive for mixed cryoglobulinemia caused by Sjögren's syndrome. The patient was better after immunosuppressive therapy, with the disappearance of clinical symptoms and the recovery of baseline renal function.

CONCLUSION

We report on this case and discuss a possible link between spontaneous rupture of kidney and mixed cryoglobulinemia-associated Sjögren's syndrome.

摘要

背景

肾自发性破裂并不常见，主要由肾肿瘤引起。仅有少数病例由血管炎导致。我们在此报告首例因混合性冷球蛋白血症引起的肾自发性破裂病例。

病例介绍

一名44岁男性，突发发热、急性肺水肿、无外伤史的左侧胁腹疼痛，以及进展迅速的肾衰竭，需要进行透析治疗。腹部计算机断层扫描显示左肾周围有巨大血肿。在保守治疗期间，患者接受了肾活检，结果显示为肾血管炎、膜增生性肾小球肾炎伴毛细血管内微血栓形成。检测结果显示由干燥综合征引起的混合性冷球蛋白血症呈阳性。患者在接受免疫抑制治疗后病情好转，临床症状消失，肾功能恢复至基线水平。