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[连续两次肾移植中膜内肾小球肾炎的复发]

[Recurrence of intramembraneous glomerulonephritis in 2 consecutive kidney transplantations].

作者信息

Schmidt P, Kerjaschki D, Syré G, Pils P, Kopsa H, Zazgornik J, Balcke P, Stemberger H

出版信息

Schweiz Med Wochenschr. 1978 May 27;108(21):781-8.

PMID:349682
Abstract

A case of dense intramembranous deposit disease, partial lipodystrophy, hypocomplementemia, and nephritic factor-like activity in the serum is presented. Recurrence of underlying renal disease was noted in two consecutive renal allografts. The first transplant was lost 7 months after implantation, chronic renal rejection being an additional cause of graft failure. A favourable clinical course, however, was observed after the second renal transplantation. 22 months after surgery, the patient was fully rehabilitated and transplant function only slightly reduced despite electron microscopic evidence of typical dense intramembranous deposit lesions. Low C3-serum complement and normal C4-serum complement levels were constant findings throughout observation time. The case supports the assumption that patients with dense intramembranous deposit disease should not be excluded from renal transplantation As shown in the literature, maintenance of satisfactory graft function is usually obtained for a long period of time despite recurrence of original disease.

摘要

本文报告1例致密内皮下沉积病、部分脂肪营养不良、低补体血症及血清中类肾炎因子活性的病例。在连续两次肾移植中均发现潜在肾病复发。第一次移植肾在植入后7个月丢失,慢性肾排斥是移植失败的另一个原因。然而,第二次肾移植后观察到良好的临床过程。术后22个月,患者完全康复,尽管电镜显示有典型的致密内皮下沉积病变,但移植肾功能仅略有下降。在整个观察期间,血清补体C3水平低而C4水平正常是持续存在的表现。该病例支持这样一种假设,即致密内皮下沉积病患者不应被排除在肾移植之外。如文献所示,尽管原发病复发,但通常能长期维持满意的移植肾功能。

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