Department of Medicine, Icahn School of Medicine at Mount Sinai, USA.
Department of Pathology, Icahn School of Medicine at Mount Sinai, USA.
Intern Med. 2023 Nov 1;62(21):3183-3186. doi: 10.2169/internalmedicine.1415-22. Epub 2023 Mar 15.
A 58-year-old man with human immunodeficiency virus (HIV) infection presented with a week-long history of gross hematuria, nephrotic proteinuria, and acute kidney injury. The patient was non-adherent with combination antiretroviral therapy. A kidney biopsy showed cellular crescents with disruption of Bowman's capsule, C3-dominant immune complex deposition, consistent with HIV-associated immune complex kidney disease (HIVICK). During the course, his worsening kidney function warranted initiation of hemodialysis. This case highlights the fact that HIV patients are at an increased risk of developing HIVICK, especially in the setting of non-adherence. A greater understanding of HIVICK among HIV patients should promote additional investigation into its etiology and viable treatments.
一名 58 岁男性，患有人类免疫缺陷病毒 (HIV) 感染，出现长达一周的肉眼血尿、肾病性蛋白尿和急性肾损伤。该患者未遵医嘱进行联合抗逆转录病毒治疗。肾脏活检显示细胞性新月体，伴有鲍曼囊破裂，C3 占优势的免疫复合物沉积，符合 HIV 相关免疫复合物性肾脏病 (HIVICK)。在病程中，他的肾功能恶化需要开始血液透析。本病例强调了 HIV 患者发生 HIVICK 的风险增加，尤其是在不遵医嘱的情况下。HIV 患者对 HIVICK 的进一步了解，应促进对其病因和可行治疗方法的进一步研究。
