Department of Nephrology, Dialysis, and Transplantation - Sahloul University Hospital, Sousse, Tunisia.
Department of Pathology - Farhat Hached University Hospital, Sousse, Tunisia.
Tunis Med. 2023 Feb 11;101(2):253-258.
In adults, minimal change disease (MCD) accounts for 15 to 25% of nephrotic syndrome (NS). Numerous reports have suggested a link between NS and atopy. However, data on treatment and prognosis of NS associated with allergy are limited.
To examine the presenting characteristics, treatments and outcomes of adults with allergic MCD in a North African center.
This was an observational study using retrospectively collected data. Patients were recruited from the Nephrology department of Sahloul Hospital (Sousse, Tunisia) from January 2006 to December 2020. Adults with a biopsy proved MCD, which was associated with atopy, were included.
Fifteen patients (eight males, age mean±SD: 34±13 years) were included. High eosinophil and immunoglobulin E (IgE) levels were noted in three and twelve patients respectively. The IgE mean level at the initial presentation was 1431 IU/ml. Allergic skin tests were positive in nine patients. All patients were treated with corticosteroids, five had anti-histamine therapy and five had hyposensitization therapy, which was successful in two patients. Thirteen patients had relapsed during follow-up. Mean eosinophil level was significantly higher in patients with frequent relapses compared to those with infrequent relapses (5415/mm³ vs. 239.12/mm³, respectively, p=0.022). Two patients had progressed to chronic renal failure.
It is important to search for atopic disorders in patients with MCD to better control this disease and use specific treatments. However, the efficacy of anti-allergic therapies has to be proven.
在成年人中，微小病变性肾病（MCD）占肾病综合征（NS）的 15%至 25%。大量报道表明 NS 与过敏之间存在关联。然而，关于过敏相关 NS 的治疗和预后的数据有限。
在北非中心研究与过敏相关的 MCD 成年患者的临床表现、治疗和结局。
这是一项回顾性研究，使用回顾性收集的数据。研究对象来自突尼斯苏塞 Sahloul 医院的肾脏病科，招募时间为 2006 年 1 月至 2020 年 12 月。研究纳入了经活检证实为 MCD 且与过敏相关的成年患者。
共纳入 15 例患者（8 名男性，年龄均数±标准差：34±13 岁）。其中 3 例患者的嗜酸性粒细胞高，12 例患者的免疫球蛋白 E（IgE）高。初诊时 IgE 平均水平为 1431IU/ml。9 例患者的过敏皮肤试验阳性。所有患者均接受了皮质类固醇治疗，5 例接受了抗组胺治疗，5 例接受了脱敏治疗，其中 2 例成功。13 例患者在随访期间复发。与复发频率较低的患者相比，复发频繁的患者的嗜酸性粒细胞水平明显更高（分别为 5415/mm³和 239.12/mm³，p=0.022）。2 例患者进展为慢性肾衰竭。
在 MCD 患者中寻找过敏障碍对于更好地控制该疾病并使用特定治疗方法很重要。然而，需要进一步证实抗过敏治疗的疗效。
