一名患有免疫球蛋白A（IgA）肾病的男性出现类似溶血性尿毒症综合征的腹泻和急性肾小管坏死。

Diarrhea and Acute Tubular Necrosis Mimicking Hemolytic Uremic Syndrome in a Man With Immunoglobulin A (IgA) Nephropathy.

作者信息

Saibaba Jayaram, Selvaraj Jayachandran, Viswanathan Stalin, Pillai Vivekanandan, Srinivas Bheemanathi H, Mandal Jharna

机构信息

Department of General Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND.

Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND.

出版信息

Cureus. 2021 Jun 1;13(6):e15369. doi: 10.7759/cureus.15369. eCollection 2021 Jun.

DOI:10.7759/cureus.15369

PMID:34239797

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8247609/

Abstract

Immunoglobulin A (IgA) nephropathy is a heterogeneous disease with variable clinical presentations ranging from asymptomatic hematuria to advanced renal failure. A young male diagnosed with IgA vasculitis (skin, joints, and gastrointestinal) one month ago and placed on oral steroids presented with acute diarrhea, hemolytic anemia, renal failure (non-dialysis requiring), altered sensorium, and thrombocytopenia. The stool was found to be positive for Shiga toxin. He improved with methylprednisolone pulse alone, and renal biopsy showed acute tubular injury.

摘要

免疫球蛋白A（IgA）肾病是一种异质性疾病，临床表现多样，从无症状血尿到晚期肾衰竭不等。一名年轻男性一个月前被诊断为IgA血管炎（皮肤、关节和胃肠道受累）并接受口服类固醇治疗，现出现急性腹泻、溶血性贫血、肾衰竭（无需透析）、意识改变和血小板减少。粪便检测发现志贺毒素呈阳性。仅使用甲泼尼龙冲击治疗后病情好转，肾活检显示急性肾小管损伤。