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一名55岁男性下肢皮疹:一例免疫球蛋白A(IgA)肾病。

A 55-Year-Old Male Presenting With a Lower Extremity Rash: A Case of Immunoglobulin A (IgA) Nephropathy.

作者信息

Denha Eric, Rahim Ali, Modi Sunjay, Oyibo Oghenekpaobor, Scott Megan

机构信息

Internal Medicine, Henry Ford Health System, Detroit, USA.

Anaesthesiology, Henry Ford Health System, Detroit, USA.

出版信息

Cureus. 2021 Mar 29;13(3):e14165. doi: 10.7759/cureus.14165.

Abstract

Immunoglobulin A (IgA) nephropathy, mesangial deposition of IgA in renal parenchyma, typically presents with hematuria and proteinuria. Leukocytoclastic vasculitis (LCV), a small-vessel vasculitis, can present secondary to IgA. We will discuss a case of secondary IgA nephropathy with concomitant LCV in a patient with reactivated hepatitis C. A 55-year-old male with decompensated alcoholic cirrhosis presented for a bilateral lower-extremity rash. The patient was diagnosed with IgA nephropathy, by kidney biopsy, and skin biopsy showing LCV. Further investigation revealed hepatitis C viral load was 275,000. We present a rare presentation of secondary IgA nephropathy with concomitant LCV, which we hypothesize was secondary to reactivation of hepatitis C.

摘要

免疫球蛋白A(IgA)肾病,即IgA在肾实质中的系膜沉积,通常表现为血尿和蛋白尿。白细胞破碎性血管炎(LCV)是一种小血管炎,可继发于IgA。我们将讨论一例丙型肝炎复发患者继发IgA肾病合并LCV的病例。一名55岁男性,患有失代偿性酒精性肝硬化,因双侧下肢皮疹前来就诊。经肾活检诊断为IgA肾病,皮肤活检显示为LCV。进一步检查发现丙型肝炎病毒载量为275,000。我们报告了一例罕见的继发IgA肾病合并LCV的病例,我们推测这是丙型肝炎复发所致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8dd/8080951/4650bb2ace66/cureus-0013-00000014165-i01.jpg

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