Myoga Hiroaki, Akimoto Tetsu, Mato Naoko, Nakaya Takakiyo, Murakami Takuya, Yoshizawa Hiromichi, Nakagawa Saki, Miki Atsushi, Masuda Takahiro, Kobayashi Takahisa, Ono Yuko, Saito Osamu, Ueda Yoshihiko, Muto Shigeaki, Nagata Daisuke
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan.
Division of Pulmonary Medicine, Department of Internal Medicine, Jichi Medical University, Japan.
Intern Med. 2017 Dec 15;56(24):3317-3322. doi: 10.2169/internalmedicine.9224-17. Epub 2017 Oct 11.
A 68-year-old man was admitted to our hospital to undergo an examination for nephrotic syndrome while concurrently complicated with recurrent thymoma in the parietal pleura and retroperitoneum. He had been diagnosed with invasive thymoma and had undergone thymo-thymectomy seven years previously. Based on the renal biopsy findings, his nephrotic syndrome was ascribed to minimal change disease. He was treated with corticosteroid monotherapy, which resulted in complete remission six months later, despite the fact that the recurrent thymoma remained. The role of thymoma in the pathogenesis of paraneoplastic glomerulopathy and the therapeutic concerns that emerged in this case are also discussed.
一名68岁男性因肾病综合征入院检查,同时并发壁层胸膜和腹膜后复发性胸腺瘤。他曾被诊断为侵袭性胸腺瘤,7年前接受了胸腺切除术。根据肾活检结果,他的肾病综合征归因于微小病变病。他接受了皮质类固醇单药治疗,尽管复发性胸腺瘤仍然存在,但6个月后完全缓解。本文还讨论了胸腺瘤在副肿瘤性肾小球病发病机制中的作用以及该病例中出现的治疗问题。