Taguchi Kensei, Mitsuishi Yuta, Kimura Koki, Ito Sakuya, Fukami Kei
Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Japan.
Research Institute of Medical Mass Spectrometry, Kurume University School of Medicine, Japan.
Intern Med. 2025 May 1;64(9):1380-1387. doi: 10.2169/internalmedicine.4301-24. Epub 2024 Sep 18.
Nephrotic syndrome (NS) predisposes patients to immunocompromised hosts owing to the loss of immunoglobulins, immunosuppressant use, and edema complications. In addition, aging impairs the immune system; thus, elderly individuals with NS are vulnerable to infection. Nocardiosis is not a common disease; however, once infected, it can disseminate hematogenously, causing serious health problems. An 88-year-old woman with amyloid light chain amyloidosis-induced NS was treated with prednisolone and tacrolimus and developed nocardiosis and invasive aspergillosis. Protecting the skin and wounds from direct exposure to nocardia is important. Physicians should consider the safe dose and treatment period of immunosuppressants in elderly patients with NS.
肾病综合征（NS）由于免疫球蛋白的丢失、免疫抑制剂的使用以及水肿并发症，使患者易成为免疫功能低下的宿主。此外，衰老会损害免疫系统；因此，患有NS的老年人易受感染。诺卡菌病并不常见；然而，一旦感染，它可通过血液传播，导致严重的健康问题。一名88岁患有轻链淀粉样变所致NS的女性接受泼尼松龙和他克莫司治疗后，发生了诺卡菌病和侵袭性曲霉病。保护皮肤和伤口免受诺卡菌直接暴露很重要。医生应考虑NS老年患者免疫抑制剂的安全剂量和治疗周期。
