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一例罕见的IgA为主型感染后肾小球肾炎:病例报告及文献复习

An unusual case of IgA-dominant postinfectious glomerulonephritis: a case report and review of the literature.

作者信息

Wagrowska-Danilewicz M, Danilewicz M, Fisiak I, Piskorska J

机构信息

Małgorzata Wągrowska-Danilewicz MD, PhD, Department of Nephropathology, Medical University of Lodz, Pomorska 251, 92-216 Lodz, Poland, tel./fax +48 42 675 76 33, e-mail:

出版信息

Pol J Pathol. 2016 Jun;67(2):179-82. doi: 10.5114/pjp.2016.61455.

Abstract

We report a case of IgA-dominant postinfectious glomerulonephritis in a 49-year-old man presenting with acute kidney injury, nephrotic range proteinuria and hematuria. He suffered from ischemic heart disease, cardiac insufficiency, mitral regurgitation, tricuspid insufficiency, septal aneurysm and hypertension. Renal biopsy revealed segmental and focal endocapillary and mesangial hypercellularity, and thickening of the glomerular capillary wall. Immunofluorescence showed co-dominant strong coarse granular immunostaining of IgA, IgG and C3 mainly along the glomerular capillary wall. On electron microscopy some large subepithelial hump-shaped deposits were present. In summary, this case demonstrates the presence of a broad spectrum of glomerular histological findings in postinfectious glomerulonephritis.

摘要

我们报告一例49岁男性的IgA主导型感染后肾小球肾炎,该患者表现为急性肾损伤、肾病范围蛋白尿和血尿。他患有缺血性心脏病、心脏功能不全、二尖瓣反流、三尖瓣反流、室间隔瘤和高血压。肾活检显示节段性和局灶性毛细血管内和系膜细胞增多,以及肾小球毛细血管壁增厚。免疫荧光显示IgA、IgG和C3主要沿肾小球毛细血管壁呈共显性强粗颗粒状免疫染色。电子显微镜检查发现一些大的上皮下驼峰状沉积物。总之,该病例表明感染后肾小球肾炎存在广泛的肾小球组织学表现。

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