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混合性结缔组织病患者的肾小球病。

Collapsing glomerulopathy in a patient with mixed connective tissue disease.

机构信息

Division of Nephrology, Hypertension and Renal Transplantation, University of Florida, 1600 SW Archer Road, Gainesville, FL, 32610, USA.

出版信息

CEN Case Rep. 2021 May;10(2):189-193. doi: 10.1007/s13730-020-00542-1. Epub 2020 Oct 14.

Abstract

Collapsing glomerulopathy (CG) is a distinct podocytopathy characterized by the global or segmental collapse of glomerular capillary tuft with overlying podocyte hypertrophy and hyperplasia. CG has been associated with numerous etiologies, including infections, autoimmune disorders, drugs, and malignancies. Anecdotal reports of CG in patients with mixed connective tissue disease (MCTD) have been reported in the literature. We report a case of a 53-year-old female who presented to us with acute kidney injury and proteinuria. The patient underwent renal biopsy for further evaluation of her proteinuria, and was diagnosed to have collapsing glomerulopathy. The patient was subsequently diagnosed with MCTD, given her constellation of symptoms and serology titers. The patient was started on prednisone with subsequent stabilization of renal function and reduction of proteinuria and continues to be in remission. We report our case to highlight the association between collapsing glomerulopathy and MCTD and the potential role of steroids as first-line therapy in such cases.

摘要

塌陷性肾小球病 (CG) 是一种独特的足细胞病,其特征是肾小球毛细血管丛的整体或节段性塌陷,伴有覆盖的足细胞肥大和增生。CG 与许多病因有关,包括感染、自身免疫性疾病、药物和恶性肿瘤。文献中有关于混合性结缔组织病 (MCTD) 患者 CG 的病例报告。我们报告了一例 53 岁女性,因急性肾损伤和蛋白尿就诊。为进一步评估蛋白尿,患者行肾活检,诊断为塌陷性肾小球病。鉴于患者的症状和血清学滴度,随后诊断为 MCTD。患者开始接受泼尼松治疗,随后肾功能稳定,蛋白尿减少,目前处于缓解期。我们报告我们的病例,以强调 CG 与 MCTD 之间的关联,以及在这种情况下类固醇作为一线治疗的潜在作用。

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Collapsing glomerulopathy in a patient with mixed connective tissue disease.
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