两名酒精性肝硬化患者出现以大量线圈样沉积物为特征的IgA肾病。
IgA nephropathy featuring massive wire loop-like deposits in two patients with alcoholic cirrhosis.
作者信息
Takada Daisuke, Sumida Keiichi, Sekine Akinari, Hazue Ryo, Yamanouchi Masayuki, Suwabe Tatsuya, Hayami Noriko, Hoshino Junichi, Sawa Naoki, Takaichi Kenmei, Fujii Takeshi, Ohashi Kenichi, Ubara Yoshifumi
机构信息
Nephrology Center, Toranomon Hospital Kajigaya, 1-3-1, Takatsu, Kawasaki, Kanagawa, 213-8587, Japan.
The Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan.
出版信息
BMC Nephrol. 2017 Dec 13;18(1):362. doi: 10.1186/s12882-017-0769-1.
BACKGROUND
Various renal manifestations are known to develop in patients with liver disease, including chronic hepatitis and cirrhosis.
CASE PRESENTATION
We evaluated renal disease in two 47-year-old Japanese men with liver cirrhosis and chronic alcoholism for 34 years and 27 years, respectively. Renal biopsy demonstrated massive wire loop-like deposits in the subendothelial space of the glomerular basement membrane and in the mesangium. However, immunofluorescence was only positive for IgA and C3, and electron microscopy did not reveal any organized structures in the electron-dense deposits. IgA nephropathy was diagnosed, although the features were different from primary IgA nephropathy. Both patients had portosystemic shunts associated with liver cirrhosis. Their renal deposits and proteinuria resolved completely after 1 year of steroid therapy.
CONCLUSION
Alcohol abuse may have contributed to development of secondary IgA nephropathy in these two patients, probably via their portosystemic shunts.
背景
已知肝病患者会出现各种肾脏表现，包括慢性肝炎和肝硬化。
病例报告
我们评估了两名47岁的日本男性患者的肾脏疾病，他们分别有34年和27年的肝硬化及慢性酒精中毒病史。肾活检显示肾小球基底膜内皮下间隙和系膜中有大量铁丝圈样沉积物。然而，免疫荧光仅对IgA和C3呈阳性，电子显微镜检查未在电子致密沉积物中发现任何有组织结构。尽管其特征与原发性IgA肾病不同，但仍诊断为IgA肾病。两名患者均有与肝硬化相关的门体分流。经过1年的类固醇治疗后，他们的肾脏沉积物和蛋白尿完全消失。
结论
酒精滥用可能通过门体分流导致了这两名患者继发性IgA肾病的发生。
Zotero 插件