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散发性髓质囊性肾病伴快速进行性肾功能不全和肾肿大合并特发性结节性肾小球硬化症 1 例罕见报告。

A Rare Case of Sporadic Medullary Cystic Kidney Disease with Rapidly Progressive Renal Dysfunction and Renal Enlargement Complicated by Idiopathic Nodular Glomerulosclerosis.

机构信息

Internal Medicine 1, Hamamatsu University School of Medicine, Japan.

Postgraduate Clinical Education Center, Hamamatsu University School of Medicine, Japan.

出版信息

Intern Med. 2024 Sep 1;63(17):2439-2444. doi: 10.2169/internalmedicine.2866-23. Epub 2024 Feb 1.

DOI:10.2169/internalmedicine.2866-23
PMID:38296480
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11442915/
Abstract

An 81-year-old man with hypertension and a history of smoking presented with renal enlargement and progressive renal dysfunction despite no family history of kidney disease. A renal biopsy revealed diffuse tubular, dilated, and atrophic distal tubules with cystic formation and thin irregularities in the tubular basement membrane. Although no known genetic abnormalities were detected, the patient was diagnosed with medullary cystic kidney disease (MCKD). In addition, idiopathic nodular glomerulosclerosis, which is characterized by significant mesangial expansion and accentuated glomerular nodularity and is associated with hypertension and cigarette smoking, was identified as a complication of MCKD. We herein report a rare case of sporadic MCKD with idiopathic nodular glomerulosclerosis.

摘要

一位 81 岁的男性,患有高血压和吸烟史,尽管没有家族性肾病病史,但出现了肾脏增大和进行性肾功能障碍。肾活检显示弥漫性管状扩张和萎缩的远端肾小管,伴有囊性形成和管状基底膜的不规则变薄。尽管未发现已知的遗传异常,但该患者被诊断为髓质囊性肾病(MCKD)。此外,还发现特发性结节性肾小球硬化症,其特征为显著的系膜扩张和肾小球结节性增强,并与高血压和吸烟有关,这是 MCKD 的一种并发症。我们在此报告一例罕见的散发性 MCKD 合并特发性结节性肾小球硬化症的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d63f/11442915/fe448b5b4a6e/1349-7235-63-2439-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d63f/11442915/222f87d00fcf/1349-7235-63-2439-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d63f/11442915/0aca384a19e1/1349-7235-63-2439-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d63f/11442915/c85897d0cde9/1349-7235-63-2439-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d63f/11442915/388118c9b47c/1349-7235-63-2439-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d63f/11442915/fe448b5b4a6e/1349-7235-63-2439-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d63f/11442915/222f87d00fcf/1349-7235-63-2439-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d63f/11442915/0aca384a19e1/1349-7235-63-2439-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d63f/11442915/c85897d0cde9/1349-7235-63-2439-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d63f/11442915/388118c9b47c/1349-7235-63-2439-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d63f/11442915/fe448b5b4a6e/1349-7235-63-2439-g005.jpg

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本文引用的文献

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Medullary Cystic Kidney Disease and Focal Segmental Glomerulosclerosis Caused by a Compound Heterozygous Mutation in TTC21B.由TTC21B复合杂合突变引起的髓质囊性肾病和局灶节段性肾小球硬化症。
Intern Med. 2020 Jul 15;59(14):1735-1738. doi: 10.2169/internalmedicine.4266-19. Epub 2020 Apr 2.
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Rapidly Progressive Renal Dysfunction in Two Elderly Patients with Renal Enlargement and Medullary Cystic Kidney Disease-like Acute Tubulointerstitial Injury.两名老年患者出现快速进展性肾功能障碍,伴有肾脏肿大及类似髓质囊性病的急性肾小管间质损伤
Intern Med. 2016;55(20):3001-3007. doi: 10.2169/internalmedicine.55.6882. Epub 2016 Oct 15.
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Contribution of the TTC21B gene to glomerular and cystic kidney diseases.
TTC21B基因对肾小球和囊性肾病的作用。
Nephrol Dial Transplant. 2017 Jan 1;32(1):151-156. doi: 10.1093/ndt/gfv453.
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A case of sporadic medullary cystic kidney disease type 1 (MCKD1) with kidney enlargement complicated by IgA nephropathy.一例散发型1型髓质囊性肾病(MCKD1)伴肾肿大并合并IgA肾病。
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