Espinosa-Figueroa Jose Luis, Cano-Megías Marta, Martínez-Miguel Patricia, Velo-Plaza Mercedes
Nephrology, Hospital Universitario Principe de Asturias, Alcala de Henares, Spain.
Nephrology, Hospital Clínico Universitario San Carlos, Madrid, Spain.
BMJ Case Rep. 2018 Feb 23;2018:bcr-2017-222979. doi: 10.1136/bcr-2017-222979.
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.
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。