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复发性感染后肾小球肾炎:一种与C3肾小球病相符的不寻常病程。

Recurrent postinfectious glomerulonephritis: an unusual evolution compatible with C3 glomerulopathy.

作者信息

Espinosa-Figueroa Jose Luis, Cano-Megías Marta, Martínez-Miguel Patricia, Velo-Plaza Mercedes

机构信息

Nephrology, Hospital Universitario Principe de Asturias, Alcala de Henares, Spain.

Nephrology, Hospital Clínico Universitario San Carlos, Madrid, Spain.

出版信息

BMJ Case Rep. 2018 Feb 23;2018:bcr-2017-222979. doi: 10.1136/bcr-2017-222979.

Abstract

Acute endocapillary glomerulonephritis, as its name suggests, is a one-time process, which usually resolves within weeks. However, in a small percentage of patients, the disease becomes chronic. In these cases, a deregulation in the alternative complement pathway, which can be caused by mutations or autoantibodies, has been proposed as a pathophysiological mechanism. As a result, the alternative complement pathway remains active after resolution of infection. We report a patient with two episodes of acute renal failure, both times diagnosed by renal biopsy of acute endocapillary glomerulonephritis, with slow recovery after two episodes of low-serum complement C3, haematuria and proteinuria.

摘要

急性毛细血管内增生性肾小球肾炎,顾名思义,是一个一次性过程,通常在数周内痊愈。然而,一小部分患者会发展为慢性疾病。在这些病例中,有人提出替代补体途径的失调,这可能由突变或自身抗体引起,是一种病理生理机制。因此,感染消退后替代补体途径仍保持活跃。我们报告了一名有两次急性肾衰竭发作的患者,两次均经肾活检诊断为急性毛细血管内增生性肾小球肾炎,两次发作后血清补体C3降低、血尿和蛋白尿,恢复缓慢。

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本文引用的文献

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C3 glomerulopathy: consensus report.C3 肾小球病:共识报告。
Kidney Int. 2013 Dec;84(6):1079-89. doi: 10.1038/ki.2013.377. Epub 2013 Oct 30.
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Treatment options for C3 glomerulopathy.C3 肾小球病的治疗选择。
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