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伴有结节性多动脉炎和多发性骨髓瘤的急性肾衰竭

Acute renal failure with polyarteritis nodosa and multiple myeloma.

作者信息

Williams A J, Newland A C, Marsh F P

出版信息

Postgrad Med J. 1985 May;61(715):445-8. doi: 10.1136/pgmj.61.715.445.

DOI:10.1136/pgmj.61.715.445
PMID:2862624
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2418257/
Abstract

A patient who presented with acute renal failure due to renal cortical necrosis is described. Renal biopsy showed cortical infarction and angiography demonstrated aneurysms in the renal, splenic and hepatic circulations. Concurrently he was found to have an IgA kappa paraprotein with bone marrow changes diagnostic of multiple myeloma. He was treated with haemodialysis, immunosuppressive drugs and plasma exchange but died 3 months after presentation.

摘要

描述了一名因肾皮质坏死导致急性肾衰竭的患者。肾活检显示皮质梗死，血管造影显示肾、脾和肝循环中有动脉瘤。同时发现他存在IgA κ副蛋白，骨髓改变诊断为多发性骨髓瘤。他接受了血液透析、免疫抑制药物和血浆置换治疗，但在就诊后3个月死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd08/2418257/f37f2b2fc820/postmedj00111-0068-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd08/2418257/9241b17ffdc7/postmedj00111-0068-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd08/2418257/f37f2b2fc820/postmedj00111-0068-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd08/2418257/9241b17ffdc7/postmedj00111-0068-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd08/2418257/f37f2b2fc820/postmedj00111-0068-b.jpg

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本文引用的文献

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The role of cryoglobulins and immune complexes in vasculitis.冷球蛋白和免疫复合物在血管炎中的作用。
J Allergy Clin Immunol. 1980 Oct;66(4):269-73. doi: 10.1016/0091-6749(80)90020-2.
2
Proliferative glomerulonephropathy in multiple myeloma.多发性骨髓瘤中的增殖性肾小球肾炎
J Pathol. 1980 Apr;130(4):229-36. doi: 10.1002/path.1711300404.
3
Renal disease in essential mixed cryoglobulinaemia. Long-term follow-up of 44 patients.原发性混合性冷球蛋白血症中的肾脏疾病。44例患者的长期随访
Q J Med. 1981;50(197):1-30.
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Multiple myeloma presenting as dense deposit disease. Light chain nephropathy.表现为致密物沉积病的多发性骨髓瘤。轻链肾病。
Nephron. 1983;34(1):58-63. doi: 10.1159/000182980.
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Polyarteritis nodosa associated with acute cytomegalovirus infection.结节性多动脉炎与急性巨细胞病毒感染相关。
Ann Rheum Dis. 1981 Aug;40(4):419-21. doi: 10.1136/ard.40.4.419.
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Monoclonal gammopathy, glomerulonephritis and the nephrotic syndrome.单克隆丙种球蛋白病、肾小球肾炎与肾病综合征
Arch Intern Med. 1970 Apr;125(4):696-700.
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