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免疫触须样肾小球病:一例罕见肾小球疾病的病例研究

Immunotactoid Glomerulopathy: A Rare Glomerular Disease Case Study.

作者信息

Karanfilovski Vlatko, Ristovska Vesna, Gjorgjievski Nikola, Nikolov Igor G, Dzekova-Vidimliski Pavlina, Petrushevska Gordana

机构信息

University Hospital of Nephrology, Medical Faculty, Ss. Cyril and Methodius University- Skopje, Republic of North Macedonia.

Institute of Pathology, Medical Faculty, Ss. Cyril and Methodius University- Skopje, Republic of North Macedonia.

出版信息

Indian J Nephrol. 2023 Mar-Apr;33(2):140-143. doi: 10.4103/ijn.ijn_107_22. Epub 2022 Oct 2.

Abstract

Immunotactoid glomerulopathy (ITG) is a rare glomerular disease with variable responsiveness to the immunosuppressive therapy and with uncertain prognosis. ITG was diagnosed in two patients with type 2 diabetes mellitus with nephrotic syndrome and chronic kidney disease. The absence of diabetic retinopathy in the first case and the recent onset of diabetes in the second case accompanied with sudden increase in the 24-hour proteinuria and rapid decline in kidney function, prompted us to perform kidney biopsy. The electron microscopy set the diagnosis of ITG in both cases. There is no consensus for the treatment of ITG. The first patient was treated with combination of steroids and mycophenolate mofetil with reduction of the 24-hour proteinuria, but with persistence of the chronic kidney disease. The second patient received high doses of steroids with continuous deterioration of kidney function with the need of hemodialysis treatment.

摘要

免疫触须样肾小球病(ITG)是一种罕见的肾小球疾病,对免疫抑制治疗的反应不一,预后不明。两名患有2型糖尿病肾病综合征和慢性肾脏病的患者被诊断为ITG。第一例患者无糖尿病视网膜病变,第二例患者近期患糖尿病,伴有24小时蛋白尿突然增加和肾功能迅速下降,促使我们进行肾活检。电子显微镜检查确诊了这两例ITG。ITG的治疗尚无共识。第一例患者接受了类固醇和霉酚酸酯联合治疗,24小时蛋白尿减少,但慢性肾脏病持续存在。第二例患者接受了大剂量类固醇治疗,但肾功能持续恶化,需要进行血液透析治疗。

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