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[一名青少年的克罗恩肠炎与慢性肾小管间质性肾病]

[Crohn's enteritis and chronic tubulo-interstitial nephropathy in an adolescent].

作者信息

Larchet M, Guillot M, Mandard J C, Boutard P, Alibert L, Delmas P, Duhamel J F

机构信息

Service de Pédiatrie A, CHU Clemenceau, Caen.

出版信息

Arch Fr Pediatr. 1988 Nov;45(9):649-51.

PMID:3069071
Abstract

We report for the first time a case of Crohn's enteritis associated with a chronic tubulo-interstitial nephritis in an adolescent. The illness started insidiously in an 11 year-old boy who had suffered from failure to thrive and protracted watery diarrhea. At presentation the patient had an inflammatory bowel disease located to the left colon but no renal dysfunction. Until the age of 15, the intestinal symptoms were stable but a progressive renal insufficiency developed. A percutaneous renal biopsy was then performed which showed a widespread chronic tubulo-interstitial nephritis. Following a 6 months corticosteroid treatment, renal dysfunction seemed to be stabilized. However, delayed growth and corticosteroid dependency led to total colectomy. Pathologic examination showed granulomatosis involvement of the entire colon and severe interstitial nephritis with neither linear nor granulous deposits along tubular basement membranes. After a 2 year-delay following the colectomy, renal function was stabilized and a catch up growth was achieved.

摘要

我们首次报告了一例青少年克罗恩肠炎合并慢性肾小管间质性肾炎的病例。该疾病在一名11岁男孩中隐匿起病,他此前一直存在生长发育迟缓及持续性水样腹泻。就诊时,患者患有位于左半结肠的炎症性肠病,但无肾功能障碍。直至15岁,肠道症状保持稳定,但逐渐出现了进行性肾功能不全。随后进行了经皮肾活检,结果显示广泛的慢性肾小管间质性肾炎。经过6个月的皮质类固醇治疗,肾功能障碍似乎得到了稳定。然而,生长发育延迟和对皮质类固醇的依赖导致了全结肠切除术。病理检查显示整个结肠有肉芽肿病变,以及严重的间质性肾炎,肾小管基底膜未见线性或颗粒状沉积物。结肠切除术后2年,肾功能稳定,实现了追赶生长。

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