Koda Ryo, Itoh Ryo, Tsuchida Masafumi, Ohashi Kazumasa, Iino Noriaki, Takada Toshinori, Narita Ichiei
Department of Nephrology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan.
Department of Respiratory Medicine, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan.
Intern Med. 2018 Oct 15;57(20):2975-2980. doi: 10.2169/internalmedicine.0942-18. Epub 2018 Jun 6.
Legionella pneumonia is occasionally accompanied by renal complications; however, the cause of this remains unknown. We herein report a 70-year-old Japanese man with Legionella pneumonia who presented with hyponatremia, hypophosphatemia, and hypouricemia. The levels of urinary β2-microglobulin and N-acetyl-β-D-glucosaminidase were remarkably high, indicating severe renal tubular damage. The presence of glycosuria and aminoaciduria as well as increased fractional excretion of uric acid and decreased tubular reabsorption of phosphate indicated that the patient's condition was complicated with Fanconi syndrome. After antimicrobial therapy, the electrolyte abnormalities and renal tubular damage were completely resolved.
军团菌肺炎偶尔会伴有肾脏并发症;然而,其病因尚不清楚。我们在此报告一名70岁的日本男性军团菌肺炎患者,该患者出现低钠血症、低磷血症和低尿酸血症。尿β2-微球蛋白和N-乙酰-β-D-氨基葡萄糖苷酶水平显著升高,提示严重肾小管损伤。存在糖尿和氨基酸尿以及尿酸分数排泄增加和肾小管磷酸盐重吸收减少表明患者并发范科尼综合征。抗菌治疗后,电解质异常和肾小管损伤完全得到缓解。