Pasquali J L, Meyer P, Christmann D, Picard A, Grosshans E, Storck D
Ann Med Interne (Paris). 1987;138(2):109-13.
Renal involvement is usually considered to be rare in dermatomyositis and polymyositis. The aim of this prospective study was to reevaluate the renal changes which may occur in these two conditions. Twenty patients, 12 with dermatomyositis and 8 with polymyositis of the adult type, were investigated to determine the incidence, the severity and course of renal disease. The 24 hour proteinuria was over 0.1 g in 14 cases and greater than 1 g/24 hours in 6 cases, including one patient with the nephrotic syndrome. Microscopic haematuria was noted in 3 cases and pyuria in 8 cases. Endogenous creatinine clearance was significantly decreased (p less than 0.001) in patients with dermatomyositis compared with a control group of subjects paired for age, sex, weight and serum creatinine concentration. Renal biopsy (5 cases) showed minimal glomerular lesions (2 cases), endocapillary proliferation and extramembranous glomerulonephritis (1 cases) and amyloid deposits (1 case). Although the proteinuria, haematuria and pyuria responded to steroid therapy (except in 1 case), the creatinine clearance remained decreased during the course of steroids.
通常认为，肾受累在皮肌炎和多发性肌炎中较为罕见。这项前瞻性研究的目的是重新评估这两种疾病可能出现的肾脏变化。对20例患者进行了研究，其中12例为皮肌炎，8例为成人型多发性肌炎，以确定肾脏疾病的发病率、严重程度和病程。14例患者24小时蛋白尿超过0.1g，6例超过1g/24小时，其中1例为肾病综合征。3例出现镜下血尿，8例出现脓尿。与年龄、性别、体重和血清肌酐浓度相匹配的对照组相比，皮肌炎患者的内生肌酐清除率显著降低（p<0.001）。肾活检（5例）显示肾小球病变轻微（2例）、毛细血管内增生和膜外肾小球肾炎（1例）以及淀粉样沉积（1例）。尽管蛋白尿、血尿和脓尿对类固醇治疗有反应（1例除外），但在类固醇治疗过程中肌酐清除率仍持续降低。
