非典型抗肾小球基底膜病：经验教训
Atypical anti-glomerular basement membrane disease: lessons learned.
作者信息
Glassock Richard J
机构信息
David Geffen School of Medicine at UCLA , Laguna Niguel, Los Angeles, CA , USA.
出版信息
Clin Kidney J. 2016 Oct;9(5):653-6. doi: 10.1093/ckj/sfw068. Epub 2016 Jul 28.
Abstract
Anti-glomerular basement membrane (GBM) disease usually pursues a self-limited course, at least from the immunological perspective. In addition, circulating antibodies to cryptic, conformational epitopes within the NC1 domain of the alpha 3 chain of Type IV Collagen are commonly found at the zenith of the clinical disease. However, exceptions to these general rules do occur, as exemplified by two remarkable cases reported in this issue of the Clinical Kidney Journal. The possible explanations for and the lessons learned from these uncommon occurrences are discussed in this short commentary.
摘要
抗肾小球基底膜（GBM）疾病通常呈自限性病程，至少从免疫学角度来看是这样。此外，在临床疾病的高峰期，通常会发现针对IV型胶原α3链NC1结构域内隐蔽性构象表位的循环抗体。然而，这些一般规律也有例外情况，本期《临床肾脏杂志》报道的两个显著病例就是例证。本简短评论将讨论这些罕见病例出现的可能原因及从中吸取的经验教训。
相似文献
1
Atypical anti-glomerular basement membrane disease: lessons learned.非典型抗肾小球基底膜病：经验教训
Clin Kidney J. 2016 Oct;9(5):653-6. doi: 10.1093/ckj/sfw068. Epub 2016 Jul 28.
2
Circulating anti-glomerular basement membrane autoantibodies against α3(IV)NC1 undetectable by commercially available enzyme-linked immunosorbent assays.循环抗肾小球基底膜自身抗体针对α3(IV)NC1，无法通过市售酶联免疫吸附测定法检测。
Nephrology (Carlton). 2012 Feb;17(2):160-6. doi: 10.1111/j.1440-1797.2011.01511.x.
3
Epitope recognized by anti-glomerular basement membrane (GBM) antibody in a patient with repeated relapse of anti-GBM disease.抗肾小球基底膜 (GBM) 抗体在反复复发抗 GBM 病患者中识别的表位。
Exp Mol Pathol. 2019 Apr;107:165-170. doi: 10.1016/j.yexmp.2019.02.005. Epub 2019 Feb 25.
4
Purification of alpha chain NC1 domains of type IV collagen from bovine kidney and their application in ELISA for detecting anti-glomerular basement membrane antibodies.从牛肾中纯化IV型胶原α链NC1结构域及其在酶联免疫吸附测定法中检测抗肾小球基底膜抗体的应用。
Beijing Da Xue Xue Bao Yi Xue Ban. 2003 Oct;35(5):494-8.
5
Different immunologic properties of the globular NC1 domain of collagen type IV isolated from various human basement membranes.从各种人类基底膜分离出的IV型胶原球状NC1结构域的不同免疫特性。
Eur J Clin Invest. 1992 Feb;22(2):138-46. doi: 10.1111/j.1365-2362.1992.tb01947.x.
6
Molecular characterization of the target antigens of anti-glomerular basement membrane antibody disease.抗肾小球基底膜抗体病靶抗原的分子特征
Springer Semin Immunopathol. 2003 May;24(4):345-61. doi: 10.1007/s00281-002-0103-1.
7
Targets of alloantibodies in Alport anti-glomerular basement membrane disease after renal transplantation.肾移植后Alport抗肾小球基底膜病中同种异体抗体的靶标
Kidney Int. 1998 Mar;53(3):762-6. doi: 10.1046/j.1523-1755.1998.00794.x.
8
9
Epitope mapping of anti-glomerular basement membrane (GBM) antibodies with synthetic peptides.用合成肽对抗肾小球基底膜（GBM）抗体进行表位作图。
Clin Exp Immunol. 1996 Sep;105(3):504-10. doi: 10.1046/j.1365-2249.1996.119808.x.
10
Induction of anti-GBM nephritis in rats by recombinant alpha 3(IV)NC1 and alpha 4(IV)NC1 of type IV collagen.通过重组IV型胶原的α3(IV)NC1和α4(IV)NC1诱导大鼠抗肾小球基底膜肾炎
Kidney Int. 1998 Mar;53(3):664-71. doi: 10.1046/j.1523-1755.1998.00795.x.
引用本文的文献
1
Crescentic glomerulonephritis due to linear IgA anti-glomerular basement membrane disease: report of a rare case.新月体性肾小球肾炎由线性 IgA 抗肾小球基底膜病引起：罕见病例报告。
Braz J Med Biol Res. 2024 May 3;57:e13466. doi: 10.1590/1414-431X2024e13466. eCollection 2024.
2
Atypical anti-glomerular basement membrane disease with membranous hyperplasia: diagnostic challenges and treatment variability.伴膜性增生的非典型抗肾小球基底膜病：诊断挑战和治疗变异性。
BMC Nephrol. 2024 Apr 15;25(1):132. doi: 10.1186/s12882-024-03571-5.
3
Atypical Antiglomerular Basement Membrane Disease in a Pediatric Patient Successfully Treated with Rituximab.利妥昔单抗成功治疗一名儿科患者的非典型抗肾小球基底膜病
Case Rep Nephrol. 2021 Jul 17;2021:2586693. doi: 10.1155/2021/2586693. eCollection 2021.
4
Atypical anti-glomerular basement membrane glomerulonephritis in a patient with metastatic melanoma treated with mitogen-activated protein kinase and immune checkpoint inhibitors: a case report.一名接受丝裂原活化蛋白激酶和免疫检查点抑制剂治疗的转移性黑色素瘤患者发生非典型抗肾小球基底膜肾小球肾炎：病例报告
J Med Case Rep. 2021 Apr 3;15(1):186. doi: 10.1186/s13256-021-02766-w.
5
Seronegative Goodpasture's syndrome associated with organising pneumonia.与机化性肺炎相关的抗肾小球基底膜病（Goodpasture 综合征）血清阴性。
BMJ Case Rep. 2021 Feb 9;14(2):e239390. doi: 10.1136/bcr-2020-239390.
6
Seronegative atypical anti-glomerular basement membrane crescentic glomerulonephritis.血清阴性非典型抗肾小球基底膜新月体性肾小球肾炎
Ann Transl Med. 2019 Jun;7(11):246. doi: 10.21037/atm.2019.04.60.
7
Rituximab for Anti-Glomerular Basement Membrane Disease.利妥昔单抗治疗抗肾小球基底膜病
Kidney Int Rep. 2018 Dec 17;4(4):614-618. doi: 10.1016/j.ekir.2018.12.002. eCollection 2019 Apr.
8
A case of aggressive atypical anti-GBM disease complicated by CMV pneumonitis.抗肾小球基底膜病合并巨细胞病毒肺炎一例。
BMC Nephrol. 2019 Jan 31;20(1):29. doi: 10.1186/s12882-019-1227-z.
9
Recurrence of Goodpasture syndrome without circulating anti-glomerular basement membrane antibodies after kidney transplant, a case report.移植肾后无循环抗肾小球基底膜抗体的 Goodpasture 综合征复发：1 例报告。
BMC Nephrol. 2019 Jan 8;20(1):6. doi: 10.1186/s12882-018-1197-6.
10
Atypical Noncrescentic Antiglomerular Basement Membrane Disease With Concurrent Thin Basement Membrane Nephropathy.合并薄基底膜肾病的非典型非新月体性抗肾小球基底膜病
Kidney Int Rep. 2018 Mar 23;3(4):991-996. doi: 10.1016/j.ekir.2018.03.012. eCollection 2018 Jul.
本文引用的文献
1
Antibody-negative Goodpasture's disease.抗体阴性的肺出血肾炎综合征
NDT Plus. 2010 Jun;3(3):253-256. doi: 10.1093/ndtplus/sfq003. Epub 2010 Mar 30.
2
Frequently relapsing anti-glomerular basement membrane antibody disease with changing clinical phenotype and antibody characteristics over time.频繁复发的抗肾小球基底膜抗体病，其临床表型和抗体特征随时间变化。
Clin Kidney J. 2016 Oct;9(5):661-4. doi: 10.1093/ckj/sfw048. Epub 2016 Jun 19.
3
Multiple recurrences of anti-glomerular basement membrane disease with variable antibody detection: can the laboratory be trusted?抗肾小球基底膜病多次复发伴抗体检测结果各异：实验室检测结果可靠吗？
Clin Kidney J. 2016 Oct;9(5):657-60. doi: 10.1093/ckj/sfw038. Epub 2016 May 17.
4
Factors Associated With Pathogenicity of Anti-Glomerular Basal Membrane Antibodies: A Case Report.抗肾小球基底膜抗体致病性相关因素：一例报告
Medicine (Baltimore). 2016 May;95(19):e3654. doi: 10.1097/MD.0000000000003654.
5
The clinicopathologic characteristics and outcome of atypical anti-glomerular basement membrane nephritis.非典型抗肾小球基底膜肾炎的临床病理特征和转归。
Kidney Int. 2016 Apr;89(4):897-908. doi: 10.1016/j.kint.2016.02.001.
6
Atypical anti-glomerular basement membrane disease.非典型抗肾小球基底膜病
Clin Kidney J. 2016 Apr;9(2):211-21. doi: 10.1093/ckj/sfv140. Epub 2015 Dec 30.
7
Seronegative anti-GBM Disease with Coexistent ANCA Positivity.血清阴性抗肾小球基底膜病合并ANCA阳性
Bull Hosp Jt Dis (2013). 2014;72(4):301-4.
8
Autoimmunity to the alpha 3 chain of type IV collagen in glomerulonephritis is triggered by 'autoantigen complementarity'.肾小球肾炎中针对IV型胶原α3链的自身免疫是由“自身抗原互补性”引发的。
J Autoimmun. 2015 May;59:8-18. doi: 10.1016/j.jaut.2015.01.003. Epub 2015 Apr 2.
9
Chapter 14: Anti-glomerular basement membrane antibody glomerulonephritis.第14章：抗肾小球基底膜抗体肾小球肾炎。
Kidney Int Suppl (2011). 2012 Jun;2(2):240-242. doi: 10.1038/kisup.2012.27.
10
Circulating anti-glomerular basement membrane antibodies with predominance of subclass IgG4 and false-negative immunoassay test results in anti-glomerular basement membrane disease.循环中抗肾小球基底膜抗体以 IgG4 亚类为主且抗肾小球基底膜病免疫检测结果呈假阴性。
Am J Kidney Dis. 2014 Feb;63(2):289-93. doi: 10.1053/j.ajkd.2013.08.032. Epub 2013 Nov 1.
Zotero 插件