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妊娠期第一季度的抗肾小球基底膜肾小球肾炎。

Anti-glomerular Basement Membrane Glomerulonephritis During the First Trimester of Pregnancy.

机构信息

Division of Clinical Medicine, Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan.

Division of Clinical Medicine, Department of Obstetrics & Gynecology, Faculty of Medicine, University of Tsukuba, Japan.

出版信息

Intern Med. 2021 Mar 1;60(5):765-770. doi: 10.2169/internalmedicine.5722-20. Epub 2020 Sep 30.

Abstract

A 28-year-old woman was admitted during the eighth week of her pregnancy because her clinical course was consistent with rapid progressive glomerulonephritis (RPGN). Anti-glomerular basement membrane antibody (anti-GBM Ab) and myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA) were positive, and the anti-GBM Ab titer being extremely high. She was treated with hemodialysis, plasma exchange and prednisolone. She survived the illness; however, neither the fetus nor her kidney function could be rescued. She had human leukocyte antigen (HLA)-DRB11502:01, which differs from the DRB11501 associated with anti-GBM GN. When patients have particular symptoms, we should check the urine and serum creatinine to exclude RPGN, even in cases of pregnancy.

摘要

一位 28 岁女性在怀孕第八周时因临床表现符合急进性肾小球肾炎(RPGN)而入院。抗肾小球基底膜抗体(抗 GBM Ab)和髓过氧化物酶抗中性粒细胞胞质抗体(MPO-ANCA)阳性,抗 GBM Ab 滴度极高。患者接受了血液透析、血浆置换和泼尼松龙治疗。患者幸存下来,但胎儿和肾功能均无法挽救。患者 HLA-DRB11502:01 阳性,与抗 GBM GN 相关的 DRB11501 不同。当患者出现特定症状时,即使在妊娠期间,我们也应检查尿液和血清肌酐以排除 RPGN。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4ee/7990629/95bd8ce52d5f/1349-7235-60-0765-g001.jpg

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