与胃肠道间质瘤相关的微小病变病伴有显著升高的血清 IgE 水平：一例报告。
Minimal change disease associated with gastrointestinal stromal tumor accompanied by significantly elevated serum IgE level: a case report.
机构信息
Department of Nephrology, Aerospace Center Hospital, Beijing, 100049, China.
Health Management Center, Aerospace General Hospital, Beijing, China.
出版信息
BMC Nephrol. 2022 Apr 11;23(1):139. doi: 10.1186/s12882-022-02775-x.
BACKGROUND
Minimal change disease (MCD) is a common cause of the nephrotic syndrome. Several studies have shown an increased incidence of cancer in patients with MCD. However, there are no reports on the association between MCD and gastrointestinal stromal tumor (GIST).
CASE PRESENTATION
We report a case of a 66-year-old female with severe nephrotic syndrome and concomitant duodenal GIST. Immunoglobulin test showed a significant increase of IgE levels. The diagnosis of renal histopathology was MCD with subacute tubulointerstitial injury. The combination of preoperative Imatinib mesylate chemotherapy and tumor excision was accompanied by significant remission of proteinuria, and IgE level decreasing, without immunosuppressivetherapy.
CONCLUSIONS
It is the first case report that MCD was associated with GIST and elevated IgE level. Clinically, in patients with elevated IgE level associated with nephrotic syndrome, the possibility of tumor must be taken into account when allergic factors are excluded.
背景
微小病变病（MCD）是肾病综合征的常见病因。多项研究表明 MCD 患者的癌症发病率增加。然而，目前尚无 MCD 与胃肠道间质瘤（GIST）之间关联的报道。
病例介绍
我们报告了一例 66 岁女性，患有严重肾病综合征和十二指肠 GIST。免疫球蛋白检测显示 IgE 水平显著升高。肾脏组织病理学诊断为 MCD 伴亚急性肾小管间质性损伤。术前甲磺酸伊马替尼化疗联合肿瘤切除，同时伴有蛋白尿显著缓解，IgE 水平下降，未进行免疫抑制治疗。
结论
这是首例 MCD 与 GIST 和 IgE 水平升高相关的病例报告。临床上，在排除过敏因素时，对于伴有肾病综合征和 IgE 水平升高的患者，必须考虑到肿瘤的可能性。
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