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孕早期突发虚脱:以塌陷性肾小球病继发的超急性肾衰竭为狼疮首发表现的病例报告

Sudden Collapse in the First Trimester: Report of Hyperacute Renal Failure Secondary to Collapsing Glomerulopathy as the Initial Presentation of Lupus.

作者信息

Sethi Pooja, Treece Jennifer, Onweni Chidinma

机构信息

Department of Cardiology, Quillen College of Medicine, East Tennessee State University.

Internal Medicine, Quillen College of Medicine, East Tennessee State University.

出版信息

Cureus. 2017 Jul 24;9(7):e1509. doi: 10.7759/cureus.1509.

Abstract

Hyperacute renal failure is rarely the initial presentation of systemic lupus erythematosus (SLE). Pregnancy can predispose untreated lupus nephritis to acute renal failure. Collapsing glomerulopathy (CG) type of renal failure is not a new clinicopathological entity. There have been documented cases prior to 1979. It is thought that detection bias coupled with the predilection for HIV has caused this form of glomerulopathy to be incorrectly named or diagnosed as 'malignant focal segmental glomerulosclerosis (FSGS)'. This is a case of CG described in lupus nephritis. We present a case of untreated lupus in a female in whom pregnancy triggered the exacerbation of lupus nephritis that presented as collapsing glomerulopathy.

摘要

超急性肾衰竭很少是系统性红斑狼疮(SLE)的初始表现。妊娠可使未经治疗的狼疮性肾炎易发展为急性肾衰竭。塌陷性肾小球病(CG)型肾衰竭并非一种新的临床病理实体。1979年之前就已有相关病例记载。有人认为,检测偏倚加上对HIV的偏好导致这种肾小球病形式被错误命名或诊断为“恶性局灶节段性肾小球硬化(FSGS)”。这是一例狼疮性肾炎中描述的CG病例。我们报告一例女性未治疗的狼疮病例,该患者妊娠引发狼疮性肾炎加重,表现为塌陷性肾小球病。

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本文引用的文献

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Epidemiology of systemic lupus erythematosus.系统性红斑狼疮的流行病学
Expert Rev Clin Immunol. 2017 Aug;13(8):799-814. doi: 10.1080/1744666X.2017.1327352. Epub 2017 May 16.
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Pregnancy-related acute kidney injury: An analysis of 165 cases.妊娠相关急性肾损伤:165例病例分析
Indian J Nephrol. 2017 Mar-Apr;27(2):113-117. doi: 10.4103/0971-4065.194394.
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Collapsing glomerulopathy in systemic lupus erythematosus.系统性红斑狼疮中的塌陷性肾小球病
BMJ Case Rep. 2017 Feb 27;2017:bcr2016217840. doi: 10.1136/bcr-2016-217840.
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Collapsing glomerulopathy associated with pulmonary tuberculosis.与肺结核相关的塌陷性肾小球病
Indian J Nephrol. 2016 Sep;26(5):373-375. doi: 10.4103/0971-4065.175981.
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Current views on collapsing glomerulopathy.关于塌陷性肾小球病的当前观点。
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