Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Japan.
Department of Pathology, Fukuoka University School of Medicine, Japan.
Intern Med. 2022 Mar 15;61(6):865-869. doi: 10.2169/internalmedicine.7885-21. Epub 2021 Aug 31.
We herein report a 43-year-old woman with Buerger's disease who presented with nephrotic syndrome, renal dysfunction, and mild hypertension. A kidney biopsy revealed focal segmental glomerulosclerosis (FSGS), but there were no findings associated with frequent secondary FSGS or a history of long-term hypertension. A small focal renal infarction was seen on Tc-dimercaptosuccinic acid renal scintigraphy, suggesting that FSGS was due to renal microinfarction associated with Buerger's disease. After the commencement of angiotensin-converting enzyme inhibitor therapy, the hypertension immediately improved, along with significant attenuation of proteinuria. Renal ischemia by vasoconstriction of the glomerular efferent arterioles in association with Buerger's disease may result in glomerular hyperfiltration followed by FSGS.
我们在此报告一例 43 岁女性，患有伯格氏病，表现为肾病综合征、肾功能不全和轻度高血压。肾活检显示局灶节段性肾小球硬化症（FSGS），但无常见继发性 FSGS 或长期高血压病史的相关发现。Tc-二巯丁二酸肾闪烁扫描显示存在小局灶性肾梗死，提示 FSGS 是由与伯格氏病相关的肾微梗死引起的。开始使用血管紧张素转换酶抑制剂治疗后，高血压立即得到改善，蛋白尿显著减轻。伯格氏病导致肾小球输出小动脉收缩性肾缺血可能导致肾小球高滤过，继而引发 FSGS。
