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[结节病的肾脏表现]

[Renal manifestations of sarcoidosis].

作者信息

Marti H P, Laissue J, Mihatsch M, Cottier H, Truniger B

机构信息

Medizinische Kliniken Luzern.

出版信息

Schweiz Med Wochenschr. 1988 Mar 26;118(12):413-21.

PMID:3287604
Abstract

Renal manifestations of sarcoidosis are rare. In addition to calcium nephropathy, granulomatous interstitial nephritis and glomerulo-nephritis (GN) account for most cases. The latter two manifestations are described in 4 patients and in a detailed review of the literature. In comparison to a nonselected population of sarcoidosis patients, granulomatous interstitial nephritis is found more frequently in male patients above 40 years of age; it is associated more frequently with other extrathoracic manifestations of sarcoidosis; and it causes renal insufficiency of varying degree, which is at least partially reversible with steroid therapy. Predominant findings are silent microhematuria, sterile pyuria, mild proteinuria and a variety of tubular functional disorders. Glomerulonephritis (39 observations) has been described with increasing frequency in sarcoidosis. Because of the well known immunological abnormalities of sarcoidosis, frequent association of sarcoidosis with GN could be expected but this association has not yet been proven statistically. Sarcoidosis-associated GN includes a variety of histological forms, viz. membranous, proliferative and sclerosing GN. Glomerulonephritis may appear before sarcoidosis. Conversely, both diseases may appear simultaneously, or GN may follow all other manifestations of sarcoidosis with a latency period of many years.

摘要

结节病的肾脏表现较为罕见。除了钙肾病外,肉芽肿性间质性肾炎和肾小球肾炎(GN)占大多数病例。本文描述了4例后两种表现的患者,并对相关文献进行了详细综述。与未经过挑选的结节病患者群体相比,肉芽肿性间质性肾炎在40岁以上男性患者中更为常见;它更常与结节病的其他胸外表现相关;并且它会导致不同程度的肾功能不全,类固醇治疗至少可使其部分逆转。主要表现为无症状性镜下血尿、无菌性脓尿、轻度蛋白尿以及各种肾小管功能障碍。在结节病中,肾小球肾炎(39例观察病例)的报道频率越来越高。由于结节病存在众所周知的免疫异常,因此可以预期结节病与GN会频繁关联,但这种关联尚未得到统计学证实。结节病相关的GN包括多种组织学类型,即膜性、增殖性和硬化性GN。肾小球肾炎可能在结节病之前出现。相反,两种疾病可能同时出现,或者GN可能在结节病的所有其他表现之后出现,潜伏期长达数年。

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