膜性肾病进展为急性新月体性快速进展性肾小球肾炎及对甲泼尼龙冲击治疗的反应

Progression of membranous nephropathy to acute crescentic rapidly progressive glomerulonephritis and response to pulse methylprednisolone.

作者信息

Koethe J D, Gerig J S, Glickman J L, Sturgill B C, Bolton W K

出版信息

Am J Nephrol. 1986;6(3):224-8. doi: 10.1159/000167129.

Abstract

There have been only sporadic reports of membranous nephropathy (MN) evolving into acute crescentic rapidly progressive glomerulonephritis (AC-RPGN). A patient with MN developed acute oliguric renal failure with a serum creatinine (SCr) of 8.4 mg/dl after 5 years of normal renal function. Biopsy now revealed epithelial crescent formation superimposed on MN. Pulse methylprednisolone resulted in significant improvement in renal function, with a SCr of 2.2 mg/dl at 6 months. No other favorable outcomes occurred in the 4 previous case reports of MN evolving into RPGN. AC-RPGN should be considered a treatable etiology of acute renal failure in the setting of MN.

摘要

仅有关于膜性肾病（MN）演变为急性新月体性快速进展性肾小球肾炎（AC-RPGN）的零星报道。一名MN患者在肾功能正常5年后出现急性少尿性肾衰竭，血清肌酐（SCr）为8.4 mg/dl。活检显示在MN基础上叠加有上皮新月体形成。静脉注射甲泼尼龙使肾功能显著改善，6个月时SCr为2.2 mg/dl。在之前4例MN演变为RPGN的病例报告中未出现其他良好结局。在MN背景下，AC-RPGN应被视为急性肾衰竭的一种可治疗病因。