Liaño F, Mampaso F, García Martín F, Pardo A, Orte L, Teruel J L, Quereda C, Ortuño J
Department of Nephrology, Hospital Ramón y Cajal, Madrid, Spain.
Nephrol Dial Transplant. 1988;3(5):684-9. doi: 10.1093/oxfordjournals.ndt.a091729.
A circulating lupus anticoagulant factor was detected in a 38-year-old man with end-stage renal disease and a 'lupus-like' syndrome with a diffuse proliferative glomerulonephritis. When treated with steroids, the 'lupus' complications were controlled and the anticoagulant factor disappeared; however, renal function did not recover and the patient commenced regular haemodialysis. Four months later the patient received a cadaver kidney transplant. At transplantation and during follow-up there was neither clinical nor laboratory evidence of lupus activity, but 19 months after transplantation, when steroids were tapered to a low dose, the lupus anticoagulant factor was detected, and renal-vein thrombosis complicated by sepsis led to the patient's death. A membranous glomerulonephritis was found on autopsy. This is the first time in which a (probably 'de novo') membranous glomerulonephritis has been detected in the allograft of a patient with circulating lupus anticoagulant factor.
在一名患有终末期肾病和伴有弥漫性增殖性肾小球肾炎的“狼疮样”综合征的38岁男性患者中检测到循环狼疮抗凝因子。用类固醇治疗后，“狼疮”并发症得到控制，抗凝因子消失；然而，肾功能并未恢复，患者开始定期进行血液透析。四个月后，患者接受了尸体肾移植。移植时及随访期间均无狼疮活动的临床或实验室证据，但移植后19个月，当类固醇减至低剂量时，检测到狼疮抗凝因子，肾静脉血栓形成并发败血症导致患者死亡。尸检发现为膜性肾小球肾炎。这是首次在患有循环狼疮抗凝因子的患者的同种异体移植中检测到（可能是“新发”）膜性肾小球肾炎。
