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成人微小病变病病例报告

Case Report of Minimal Change Disease in the Adult Population.

作者信息

Wynn Austin B, Metuku Rajesh, Santos Raul

机构信息

Osteopathic Medicine, Alabama College of Osteopathic Medicine, Dothan, USA.

Nephrology, Archbold Memorial Hospital, Thomasville, USA.

出版信息

Cureus. 2024 Jun 13;16(6):e62306. doi: 10.7759/cureus.62306. eCollection 2024 Jun.

Abstract

Minimal change disease (MCD), typically linked with pediatric nephrotic syndrome, presents challenges in early identification and diagnosis in adult populations. This case report emphasizes the importance of tailored diagnostic and treatment approaches for adults with MCD. Our patient presented with fatigue, shortness of breath, and confusion, along with other symptoms leading to a renal biopsy which confirmed MCD. This highlights the diagnostic significance of kidney biopsy in adults. While steroids remain the standard treatment, challenges such as resistance and side effects lead to the consideration of alternatives like tacrolimus. There are nuanced differences between adult and pediatric MCD presentations, for which our study calls for increased awareness among physicians. Steroids are considered a first-line treatment for MCD, but prolonged use of steroids has significantly increased risk and alternative therapies should be considered. This study presents an example of MCD in adult populations, urging ongoing research for enhanced understanding and tailored management strategies. It emphasizes the pivotal role of physician awareness, alternative treatments, and continued investigation to improve outcomes for adults with MCD.

摘要

微小病变病(MCD)通常与儿童肾病综合征相关,在成人人群的早期识别和诊断方面存在挑战。本病例报告强调了针对成人MCD患者采取量身定制的诊断和治疗方法的重要性。我们的患者出现疲劳、呼吸急促和意识模糊等症状,以及其他症状,最终通过肾活检确诊为MCD。这凸显了肾活检在成人诊断中的重要意义。虽然类固醇仍然是标准治疗方法,但诸如耐药性和副作用等挑战促使人们考虑使用他克莫司等替代疗法。成人和儿童MCD的表现存在细微差异,我们的研究呼吁医生提高对此的认识。类固醇被认为是MCD的一线治疗药物,但长期使用类固醇会显著增加风险,应考虑替代疗法。本研究展示了成人MCD的一个案例,敦促开展持续研究以增进理解并制定量身定制的管理策略。它强调了医生的认识、替代治疗以及持续调查对于改善成人MCD患者治疗效果的关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea46/11245890/f8a6551f1e9e/cureus-0016-00000062306-i01.jpg

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