Birkemeier Krista L, Hogg Ronald J, Patel Darshan B, Acosta Alisa A, Waxman Jeffrey A
Department of Radiology, Texas A&M Health Science Center, Baylor Scott & White McLane Children's Medical Center, Temple, Texas.
Department of Pediatrics, Texas A&M Health Science Center, Baylor Scott & White McLane Children's Medical Center, Temple, Texas.
Proc (Bayl Univ Med Cent). 2020 Dec 23;34(2):294-296. doi: 10.1080/08998280.2020.1860428.
Episodic (recurrent) macroscopic hematuria in patients with IgA nephropathy is usually associated with a benign prognosis, although some patients experience a transient fall in glomerular filtration rate during the episodes. We present a 15-year-old girl with mild IgA nephropathy who had multiple episodes of macroscopic hematuria associated with severe but transient decreases in estimated glomerular filtration rate, low levels of serum uric acid, and marked increases in fractional excretion of uric acid. Ultrasound studies showed marked inflammatory changes in the bladder, especially involving the trigone. Cystoscopic findings were consistent with these changes. We hypothesize that the macroscopic hematuria may have resulted, at least in part, from hyperuricosuria causing acute irritation of the bladder mucosa in the trigone area.
IgA 肾病患者的发作性（复发性）肉眼血尿通常预后良好，尽管有些患者在发作期间肾小球滤过率会短暂下降。我们报告一名 15 岁轻度 IgA 肾病女孩，她有多次肉眼血尿发作，伴有估计肾小球滤过率严重但短暂下降、血清尿酸水平降低以及尿酸排泄分数显著增加。超声检查显示膀胱有明显炎症改变，尤其是三角区。膀胱镜检查结果与这些改变一致。我们推测，肉眼血尿可能至少部分是由高尿酸尿症导致三角区膀胱黏膜急性刺激引起的。
