Belghiti D, Patey O, Berry J P, Antelin C, Hirbec G, Lagrue G
Presse Med. 1986 Nov 8;15(39):1953-5.
Classically, the histological lesion observed in a drug-or heavy metal-induced nephrotic syndrome is membranous glomerulonephritis. We report two cases of "toxic" nephrotic syndrome with unusual histological features. One was secondary to mercury intoxication and the other, to D-penicillamine in a patient with rheumatoid arthritis. In both cases, renal biopsy revealed minimal glomerular changes. The proteinuria rapidly disappeared after exposure to the toxic agent was discontinued. Genetic factors and a disregulation of the immune system with lymphokine production may be responsible for these renal changes. This study demonstrates that renal biopsy is necessary in this clinical setting.
传统上，在药物或重金属诱导的肾病综合征中观察到的组织学病变是膜性肾小球肾炎。我们报告了两例具有不寻常组织学特征的“中毒性”肾病综合征病例。一例继发于汞中毒，另一例继发于类风湿性关节炎患者服用的D-青霉胺。在这两个病例中，肾活检均显示肾小球变化轻微。停止接触有毒物质后，蛋白尿迅速消失。遗传因素以及免疫系统因淋巴因子产生而失调可能是这些肾脏变化的原因。这项研究表明，在这种临床情况下进行肾活检是必要的。
