Hara Masayuki, Kusaba Tetsuro, Ono Kenshi, Masuzawa Naoko, Nakamura Itaru, Urata Noriko, Shiraishi Hirokazu, Hara Shigeo, Konishi Eiichi, Matoba Satoaki, Shiotsu Yayoi, Tamagaki Keiichi
Department of Nephrology, Kyoto Prefectural University of Medicine, Japan.
Department of Nephrology, Omihachiman Community Medical Center, Japan.
Intern Med. 2021 Jul 1;60(13):2103-2107. doi: 10.2169/internalmedicine.6558-20. Epub 2021 Feb 8.
Glomerulopathy with fibronectin deposits (GFND) is a rare hereditary kidney disease with autosomal dominant inheritance. A 21-year-old woman who had been diagnosed with GFND 10 years ago was admitted for investigation of a rapid decline in her renal function, hemolytic anemia, and cardiac dysfunction. A renal biopsy showed GFND accompanied by extraglomerular vascular lesions. Comprehensive treatments against hypertension and anemia improved the renal function. Although there have been few reports of vascular lesions in GFND, we suspect that endothelial hyperpermeability resulting from hypertension caused the fibronectin deposition and narrowing of the extraglomerular vascular lumens, thereby accelerating hypertension and inducing hemolytic anemia.
伴纤连蛋白沉积的肾小球病(GFND)是一种罕见的常染色体显性遗传性肾脏疾病。一名10年前被诊断为GFND的21岁女性因肾功能快速下降、溶血性贫血和心脏功能障碍入院接受检查。肾活检显示GFND伴有肾小球外血管病变。针对高血压和贫血的综合治疗改善了肾功能。尽管关于GFND血管病变的报道很少,但我们怀疑高血压导致的内皮细胞高通透性引起了纤连蛋白沉积和肾小球外血管腔狭窄,从而加剧高血压并诱发溶血性贫血。