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儿科非狼疮性全满贯肾病:病例报告。

Non-lupus full house nephropathy in pediatrics: Case reports.

机构信息

Servicio de Nefrología Pediátrica, Hospital Infantil Napoleón Franco Pareja, Cartagena, Colombia; Departamento de Pediatría, Universidad de Cartagena, Cartagena, Colombia.

Departamento de Pediatría, Universidad de Cartagena, Cartagena, Colombia.

出版信息

Biomedica. 2020 Jun 15;40(2):220-227. doi: 10.7705/biomedica.4863.

Abstract

Full house nephropathy is defined as the simultaneous detection of IgA, IgG, IgM, C3, and C1q deposits by immunofluorescence, usually indicating lupus nephritis. There are patients with this immunofluorescence pattern, but with negative autoantibody serology, which means they cannot be diagnosed with systemic lupus erythematosus. Patients presenting with full house nephropathy but no other criteria for lupus are diagnosed as having nonlupus full house nephropathy. Here, we describe two cases: A male patient who debuted with rapidly progressive glomerulonephritis and a female patient with nephrotic syndrome. Both had negative autoantibody serology, findings in the renal biopsy of class IV lupus nephritis and afull house immunofluorescence pattern. Histological findings in non-lupus full house nephropathy are similar to those in lupus nephritis and, probably, similar physiopathological bases. However, prospective studies are needed to determine risk factors and the renal prognosis and to make suggestions for specific treatments.

摘要

满堂肾病定义为免疫荧光同时检测到 IgA、IgG、IgM、C3 和 C1q 沉积物,通常提示狼疮肾炎。有一些具有这种免疫荧光模式的患者,但自身抗体血清学为阴性,这意味着他们不能被诊断为系统性红斑狼疮。表现为满堂肾病但没有其他狼疮标准的患者被诊断为非狼疮满堂肾病。在这里,我们描述了两例病例:一名男性患者首次出现急进性肾小球肾炎,一名女性患者出现肾病综合征。两者的自身抗体血清学均为阴性,肾脏活检显示狼疮肾炎 IV 级且满堂免疫荧光模式。非狼疮满堂肾病的组织学表现与狼疮肾炎相似,可能具有相似的病理生理基础。然而,需要前瞻性研究来确定风险因素和肾脏预后,并提出针对特定治疗的建议。

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本文引用的文献

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Outcome of childhood-onset full-house nephropathy.儿童期起病的全肾小球疾病的转归。
Nephrol Dial Transplant. 2017 Jul 1;32(7):1194-1204. doi: 10.1093/ndt/gfw230.
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Renal-limited 'lupus-like' nephritis.肾脏局限性“狼疮样”肾炎
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Histopathology of lupus nephritis.狼疮肾炎的组织病理学。
Clin Rev Allergy Immunol. 2011 Jun;40(3):170-80. doi: 10.1007/s12016-010-8207-1.
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Full-house nephropathy in a patient with negative serology for lupus.狼疮血清学检查阴性患者的满堂亮肾病
Rheumatol Int. 2007 Jan;27(3):281-4. doi: 10.1007/s00296-006-0198-0. Epub 2006 Sep 14.

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