Siddiqui Raheel S, Sumbly Vikram, Abrudescu Adriana
Internal Medicine, Icahn School of Medicine at Mount Sinai (New York City Health and Hospitals/Queens), Jamaica, USA.
Rheumatology, Icahn School of Medicine at Mount Sinai (New York City Health and Hospitals/Queens), Jamaica, USA.
Cureus. 2021 Feb 21;13(2):e13468. doi: 10.7759/cureus.13468.
The involvement of kidneys in syphilis has been reported in the literature with the majority of cases presenting with nephrotic-range proteinuria. We report a case of rapidly proliferative glomerulonephritis in a patient with secondary syphilis. A 40-year-old male with a history of human immunodeficiency virus (HIV), chronic hepatitis B virus, and chronic kidney disease stage 2 presented with fatigue, anorexia, weight loss, arthralgia, chills, and rash throughout the body. The patient was non-compliant with HIV medication and had unprotected sexual intercourse. Labs showed blood urea nitrogen of 57 mg/dL (range: 7-23 mg/dL), creatinine 8.2 mg/dL (range: 0.5-1.3 mg/dL), and high titers of rapid plasma reagin. The biopsy showed crescentic glomerulonephritis with c3 deposition in mesangium and basement membrane. The patient responded to treatment with penicillin therapy with gradual improvement in kidney function.
文献中已报道肾脏受累于梅毒，大多数病例表现为肾病范围的蛋白尿。我们报告一例二期梅毒患者发生快速增殖性肾小球肾炎的病例。一名40岁男性，有人类免疫缺陷病毒（HIV）、慢性乙型肝炎病毒病史及慢性肾脏病2期，出现疲劳、厌食、体重减轻、关节痛、寒战及全身皮疹。该患者未遵医嘱服用HIV药物且有不安全性行为。实验室检查显示血尿素氮为57mg/dL（范围：7 - 23mg/dL），肌酐8.2mg/dL（范围：0.5 - 1.3mg/dL），快速血浆反应素滴度高。活检显示新月体性肾小球肾炎，系膜和基底膜有C3沉积。患者接受青霉素治疗后反应良好，肾功能逐渐改善。
