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高安动脉炎与继发性膜性肾病:一种罕见的关联。

Takayasu's arteritis and secondary membranous nephropathy: an exceptional association.

作者信息

Enos Daniel, Labarca Gonzalo, Hernandez Mariel, Mendez Gonzalo P

机构信息

Internal Medicine, Universidad San Sebastian, Los Ángeles, Chile.

Internal Medicine, Complejo Asistencial Dr. Victor Rios Ruiz, Los Angeles, Chile.

出版信息

BMJ Case Rep. 2021 Mar 1;14(3):e237945. doi: 10.1136/bcr-2020-237945.

Abstract

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.

摘要

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。

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本文引用的文献

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[Renal injury in Takayasu's arteritis].[高安动脉炎中的肾损伤]
Nephrol Ther. 2014 Nov;10(6):451-6. doi: 10.1016/j.nephro.2014.07.483. Epub 2014 Oct 23.
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Case Rep Nephrol Urol. 2014 Apr 1;4(1):60-9. doi: 10.1159/000360850. eCollection 2014 Jan.
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Glomerular disease associated with Takayasu arteritis: 6 cases analysis and review of the literature.
Chin Med Sci J. 2009 Jun;24(2):69-75. doi: 10.1016/s1001-9294(09)60063-8.

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