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抗磷脂抗体和抗中性粒细胞胞浆抗体在感染后肾小球肾炎中的意义

Implications of Antiphospholipid and Antineutrophilic Cytoplasmic Antibodies in the Context of Postinfectious Glomerulonephritis.

作者信息

Leifer Daniel, Butani Lavjay

机构信息

Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Department of Pediatrics, University of California Davis School of Medicine, Sacramento, CA, USA.

出版信息

Case Rep Med. 2017;2017:9896210. doi: 10.1155/2017/9896210. Epub 2017 Feb 1.

Abstract

While antineutrophil cytoplasmic antibody (ANCA) positivity has been documented in some patients with postinfectious glomerulonephritis (PIGN) and is associated with more severe disease, antiphospholipid antibodies (APA) are not known to be a common occurrence. We describe a child with severe acute kidney injury who was noted to have prolonged positivity of both ANCA and APA; a renal biopsy showed noncrescentic immune complex mediated glomerulonephritis with subepithelial deposits compatible with PIGN. He recovered without maintenance immunosuppressive therapy and at last follow-up had normal renal function. We discuss the cooccurrence and implications of ANCA and APA in children with PIGN.

摘要

虽然抗中性粒细胞胞浆抗体(ANCA)阳性在一些感染后肾小球肾炎(PIGN)患者中已有记录,且与更严重的疾病相关,但抗磷脂抗体(APA)并不常见。我们描述了一名患有严重急性肾损伤的儿童,其ANCA和APA均呈长期阳性;肾活检显示为非新月体性免疫复合物介导的肾小球肾炎,伴有与PIGN相符的上皮下沉积物。他未经维持性免疫抑制治疗即康复,最后一次随访时肾功能正常。我们讨论了PIGN患儿中ANCA和APA同时出现的情况及其意义。

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