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以IgA肾病导致肾衰竭为表现的转移性非小细胞肺癌

Metastatic Non-Small-Cell Lung Cancer Presenting as Renal Failure From IgA Nephropathy.

作者信息

Yassin Samer, Athota Sruthi, Khan Afnan, Patel Vraj, Williams James, Dwived Suyash

机构信息

Augusta University, GA, USA.

Forsyth Central High School, Cumming, GA, USA.

出版信息

J Investig Med High Impact Case Rep. 2024 Jan-Dec;12:23247096241262515. doi: 10.1177/23247096241262515.

Abstract

Studies have highlighted a potential link between malignancies and immunoglobulin A nephropathy (IgAN). In such studies, the treatment of malignancy improved the symptoms of IgAN. Here, we report a patient case involving a history of hypertension, tobacco use disorder, and chronic kidney disease (CKD) presenting with hematuria with acute renal failure secondary to IgAN per renal biopsy. Prompted by this association, a malignancy workup was performed including computed tomography (CT) body imaging and biopsies of mediastinal and cervical lymph nodes which revealed a metastatic adenocarcinoma. Current knowledge includes a general mechanism behind the development of IgAN that points toward glomerular deposition of tumor-specific immunoglobulin A (IgA) immunoglobulins. However, the association of IgAN and malignancy has no definitive management guidelines. This clinical case serves as an important contribution in the hopes of future development of guidelines regarding the surveillance and management of IgAN in the setting of malignancy.

摘要

研究突出了恶性肿瘤与免疫球蛋白A肾病(IgAN)之间的潜在联系。在此类研究中,恶性肿瘤的治疗改善了IgAN的症状。在此,我们报告一例患者病例,该患者有高血压、烟草使用障碍和慢性肾脏病(CKD)病史,经肾活检诊断为IgAN继发急性肾衰竭伴血尿。受这种关联的启发,我们进行了恶性肿瘤检查,包括全身计算机断层扫描(CT)成像以及纵隔和颈部淋巴结活检,结果显示为转移性腺癌。目前的认识包括IgAN发病背后的一般机制,该机制指向肿瘤特异性免疫球蛋白A(IgA)免疫球蛋白在肾小球的沉积。然而,IgAN与恶性肿瘤的关联尚无明确的管理指南。这个临床病例为未来制定关于在恶性肿瘤背景下监测和管理IgAN的指南做出了重要贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fea1/11295218/b732a9077ea8/10.1177_23247096241262515-fig1.jpg

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