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