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可能由未诊断出的肾细胞癌引发的抗肾小球基底膜病:一例报告

Antiglomerular Basement Membrane Disease Possibly Triggered by Undiagnosed Renal Cell Carcinoma: A Case Report.

作者信息

Rivedal Mariell, Haaskjold Yngvar Lunde, Berge Hedda, Knoop Thomas

机构信息

Department of Clinical Medicine, University of Bergen, Bergen, Norway.

Department of Medicine, Haukeland University Hospital, Bergen, Norway.

出版信息

Kidney Med. 2023 Aug 9;5(10):100709. doi: 10.1016/j.xkme.2023.100709. eCollection 2023 Oct.

Abstract

Antiglomerular basement membrane (anti-GBM) disease is a rare, small-vessel vasculitis that affects the capillary beds of the kidneys and lungs. Although exceedingly rare, several case reports have described anti-GBM disease with a concurrent cancer diagnosis, suggesting a possible correlation between these 2 conditions. Herein, we describe the first known case to our knowledge of a woman in her early 60s with simultaneous anti-GBM disease and clear cell renal cell carcinoma, in which the tumor was thought to have been the substrate for anti-GBM disease. We believe that renal cell carcinoma may have contributed to the production of anti-GBM autoantibodies and, thus, anti-GBM disease. The concurrence of these 2 conditions complicated the treatment of the patient, who was hemodialysis-dependent at the time of hospital discharge. This report highlights the importance of considering anti-GBM disease as a potential diagnosis in patients with acute kidney failure, and how important it is to identify both clear cell renal cell carcinoma and anti-GBM disease at an early stage to improve outcomes.

摘要

抗肾小球基底膜(anti-GBM)病是一种罕见的小血管血管炎,可累及肾脏和肺部的毛细血管床。尽管极为罕见,但已有数例病例报告描述了抗GBM病与癌症诊断同时存在的情况,提示这两种疾病之间可能存在关联。在此,我们报告了据我们所知的首例60岁出头女性同时患有抗GBM病和透明细胞肾细胞癌的病例,其中肿瘤被认为是抗GBM病的发病基础。我们认为肾细胞癌可能促使了抗GBM自身抗体的产生,进而导致了抗GBM病。这两种疾病的并存使患者的治疗变得复杂,患者出院时依赖血液透析。本报告强调了在急性肾衰竭患者中考虑抗GBM病作为潜在诊断的重要性,以及早期识别透明细胞肾细胞癌和抗GBM病对改善预后的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74ac/10485625/2cae111b1b5b/gr1.jpg

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