Iwakura Takamasa, Fujigaki Yoshihide, Katahashi Naoko, Sato Taichi, Ishigaki Sayaka, Tsuji Naoko, Naito Yoshitaka, Isobe Shinsuke, Ono Masashi, Sakao Yukitoshi, Tsuji Takayuki, Ohashi Naro, Kato Akihiko, Miyajima Hiroaki, Yasuda Hideo
First Department of Medicine, Hamamatsu University School of Medicine, Japan.
Intern Med. 2016;55(18):2663-8. doi: 10.2169/internalmedicine.55.6726. Epub 2016 Sep 15.
A 30-year-old woman with proteinuria first noted at 26 weeks of gestation was admitted to undergo further evaluation. A renal biopsy revealed membranous nephropathy (MN). There was no evidence of any secondary MN. Prednisolone was initiated 6 months after delivery. Four months later, her urine protein became negative. Enhanced granular staining for thrombospondin type-1 domain-containing 7A (THSD7A) in the glomeruli was retrospectively detected in a biopsy specimen. A literature review revealed that 60% of cases of THSD7A-related MN occurred in women of childbearing age. Therefore, THSD7A-related MN should be considered in female patients presenting with idiopathic MN in childbearing age.
一名30岁女性,在妊娠26周时首次发现蛋白尿,入院接受进一步评估。肾活检显示为膜性肾病(MN)。没有任何继发性MN的证据。产后6个月开始使用泼尼松龙。4个月后,她的尿蛋白转阴。回顾性检测活检标本发现肾小球中含血小板反应蛋白1型结构域7A(THSD7A)有增强的颗粒状染色。文献综述显示,60%的THSD7A相关MN病例发生在育龄女性。因此,对于育龄期出现特发性MN的女性患者,应考虑THSD7A相关MN。