Enos Daniel, Labarca Gonzalo, Hernandez Mariel, Mendez Gonzalo P
Internal Medicine, Universidad San Sebastian, Los Ángeles, Chile.
Internal Medicine, Complejo Asistencial Dr. Victor Rios Ruiz, Los Angeles, Chile.
BMJ Case Rep. 2021 Mar 1;14(3):e237945. doi: 10.1136/bcr-2020-237945.
The association between Takayasu's arteritis and membranous nephropathy is uncommon. We present the case of a 46-year-old man with Takayasu's arteritis treated over 10 years by a multidisciplinary medical team. He had an atrophic left kidney due to arterial stenosis, with a basal creatinine of 1.59 mg/dL (140.55 µmol/l). Three years ago, he presented with full nephrotic syndrome, uncontrolled blood pressure, creatinine increases to 4.5 mg/dL (basal: 1.59 mg/dL), severe hypoalbuminaemia (1.4 g/dL) and albuminuria of 24.6 g per day. He underwent percutaneous biopsy of the right kidney that showed membranous nephropathy with negative PLA2R1 and positive IgG 1, 3 and 4 subclasses. After therapy with oral prednisone and cyclophosphamide, the patient's kidney function improved, without recurrence of disease after 3 years of follow-up. Here, we present this extremely uncommon association of Takayasu's arteritis and membranous nephropathy.
高安动脉炎与膜性肾病之间的关联并不常见。我们报告一例46岁患有高安动脉炎的男性患者,该患者由多学科医疗团队治疗了10余年。由于动脉狭窄,他的左肾萎缩,基础肌酐为1.59 mg/dL(140.55 µmol/l)。三年前,他出现了完全性肾病综合征、血压控制不佳、肌酐增至4.5 mg/dL(基础值:1.59 mg/dL)、严重低白蛋白血症(1.4 g/dL)以及每日24.6 g的蛋白尿。他接受了右肾经皮活检,结果显示为膜性肾病,PLA2R1阴性,IgG 1、3和4亚类阳性。经过口服泼尼松和环磷酰胺治疗后,患者的肾功能得到改善,随访3年疾病未复发。在此,我们呈现高安动脉炎与膜性肾病这种极为罕见的关联。