Montague Emily, Hockenhull Kimberley, Lamarca Angela, Al-Sayed Tamer, Hubner Richard A
Medical Oncology, Christie NHS Foundation Trust, Manchester, UK.
Acute/Renal Medicine, Christie NHS Foundation Trust, Manchester, UK.
BMJ Case Rep. 2019 Aug 30;12(8):e227987. doi: 10.1136/bcr-2018-227987.
Paraneoplastic glomerular disease is an increasingly well-recognised entity, and a wide range of both solid and haematological malignancies have been implicated. The most common glomerular disease associated with cancer is membranous nephropathy. Only a few case reports have described an association between neuroendocrine tumours (NETs) and glomerulonephritis and only one paediatric case in relation to minimal change disease. A 76-year-old woman with a well-differentiated duodenal NET presented with nephrotic syndrome and renal biopsy was suggestive of minimal change glomerulonephritis. Standard therapy with corticosteroids brought little benefit, but a dramatic improvement was seen following initiation of systemic anticancer therapy with lanreotide, a somatostatin analogue. Less than 1 month after initiation of lanreotide, the patient was no longer in a nephrotic state, and after a further 2 months of follow-up had shown no sign of relapse.
副肿瘤性肾小球疾病是一种越来越被广泛认识的疾病实体，多种实体瘤和血液系统恶性肿瘤都与之相关。与癌症相关的最常见肾小球疾病是膜性肾病。仅有少数病例报告描述了神经内分泌肿瘤（NETs）与肾小球肾炎之间的关联，且仅有1例儿科病例与微小病变病有关。一名患有高分化十二指肠NET的76岁女性出现肾病综合征，肾活检提示微小病变性肾小球肾炎。使用糖皮质激素的标准治疗效果甚微，但在开始使用生长抑素类似物兰瑞肽进行全身抗癌治疗后，病情出现显著改善。开始使用兰瑞肽不到1个月，患者就不再处于肾病状态，经过进一步2个月的随访，未显示复发迹象。
