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一位九旬老人患风湿性多肌痛并发肾病综合征：病例报告

Polymyalgia Rheumatica Complicated by Nephrotic Syndrome in a Nonagenarian: A Case Report.

作者信息

Nakagawa Ayato, Yamamoto Natsumi, Sano Chiaki, Ohta Ryuichi

机构信息

Family Medicine, International University of Health and Welfare, Tokyo, JPN.

Community Care, Unnan City Hospital, Unnan, JPN.

出版信息

Cureus. 2024 Aug 10;16(8):e66592. doi: 10.7759/cureus.66592. eCollection 2024 Aug.

DOI:10.7759/cureus.66592
PMID:39258043
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11385428/
Abstract

This case report describes a 91-year-old bedridden man with a complex medical history who presented with fever and low oxygen saturation, suspected to be aspiration pneumonia. Further investigation revealed nephrotic syndrome, microscopic hematuria, and joint pain. The diagnosis of polymyalgia rheumatica (PMR) was considered due to the presence of characteristic symptoms and elevated inflammatory markers despite the inability to perform a kidney biopsy. The patient was treated with low-dose prednisolone (PSL), leading to significant improvement in joint pain, renal function, and overall condition. This case highlights the importance of considering PMR in elderly patients with unexplained nephrotic syndrome and systemic inflammation. Early diagnosis and corticosteroid treatment can improve clinical outcomes and enhance activities of daily living. This report underscores the need for awareness of PMR as a potential cause of nephrotic syndrome in the elderly and the effectiveness of PSL in managing such cases.

摘要

本病例报告描述了一名91岁的卧床男性，他有复杂的病史，出现发热和低氧饱和度，怀疑为吸入性肺炎。进一步检查发现患有肾病综合征、镜下血尿和关节疼痛。尽管无法进行肾活检，但由于存在特征性症状和炎症标志物升高，考虑诊断为风湿性多肌痛（PMR）。患者接受低剂量泼尼松龙（PSL）治疗后，关节疼痛、肾功能和整体状况均有显著改善。本病例强调了在患有不明原因肾病综合征和全身炎症的老年患者中考虑PMR的重要性。早期诊断和皮质类固醇治疗可改善临床结局并提高日常生活活动能力。本报告强调了认识到PMR作为老年人肾病综合征潜在病因的必要性以及PSL在管理此类病例中的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5ff/11385428/db7a21d8710e/cureus-0016-00000066592-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5ff/11385428/f36e001d5f8e/cureus-0016-00000066592-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5ff/11385428/db7a21d8710e/cureus-0016-00000066592-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5ff/11385428/f36e001d5f8e/cureus-0016-00000066592-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5ff/11385428/db7a21d8710e/cureus-0016-00000066592-i02.jpg

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本文引用的文献

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Exp Ther Med. 2023 Oct 5;26(6):543. doi: 10.3892/etm.2023.12242. eCollection 2023 Dec.
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Thrombocytopenia, Anasarca, Myelofibrosis, Renal dysfunction, and Organomegaly (TAFRO) Syndrome Initially Diagnosed as Fibromyalgia: A Case Report.最初诊断为纤维肌痛的血小板减少、全身水肿、骨髓纤维化、肾功能不全和器官肿大（TAFRO）综合征：一例报告
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