Division of Rheumatology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, No.88, Jiefang Road, Shangcheng District, Hangzhou, 310005, Zhejiang, People's Republic of China.
Division of Nephrology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, No.88, Jiefang Road, Shangcheng District, Hangzhou, 310005, Zhejiang, People's Republic of China.
Clin Rheumatol. 2019 May;38(5):1521-1528. doi: 10.1007/s10067-019-04504-6. Epub 2019 Mar 16.
Podocytic infolding glomerulopathy (PIG) is a newly proposed disease entity, and only 29 cases have been reported worldwide so far, characterized by microspheres or microtubular structures or both associated with podocytic infolding into the glomerular basement membrane (GBM) on electron microscopy. We present two new cases of PIG with connective tissue disease (CTD), one with primary Sjögren's syndrome and the other with systemic lupus erythematosus (SLE), and make a systemic review of the literature. In the entire 31 patients of PIG, 24 (77.42%) were women and seven (22.58%) were men, with an average age of 41.2 ± 15.2 (ranging from 14 to 79) years old. Almost two-thirds of patients (67.74%) were diagnosed with CTD, in which 76.19% were SLE. All patients presented with proteinuria and six (19.35%) patients were accompanied with hematuria. Serum creatinine was elevated in six (19.35%) patients. Pathological findings of all patients were consistent with PIG characteristics, and four patients with repeated renal biopsies further provided profound insights.
足细胞内褶肾小球病(PIG)是一种新提出的疾病实体,迄今为止,全世界仅报告了 29 例病例,其特征是电镜下可见与足细胞内褶到肾小球基底膜(GBM)相关的微球体或微管状结构或两者均存在。我们报告了两例新的伴有结缔组织病(CTD)的 PIG 病例,一例为原发性干燥综合征,另一例为系统性红斑狼疮(SLE),并对文献进行了系统回顾。在整个 31 例 PIG 患者中,24 例(77.42%)为女性,7 例(22.58%)为男性,平均年龄为 41.2±15.2(14 至 79 岁)。将近三分之二的患者(67.74%)被诊断为 CTD,其中 76.19%为 SLE。所有患者均表现为蛋白尿,6 例(19.35%)患者伴有血尿。6 例(19.35%)患者的血清肌酐升高。所有患者的病理发现均符合 PIG 的特征,4 例重复肾活检进一步提供了深刻的见解。