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一名慢性乙型肝炎患者中与IgA肾病及C3沉积相关的快速进展性肾小球肾炎

Rapidly Progressive Glomerulonephritis Associated With IgA Nephropathy and C3 Deposits in a Patient With Chronic Hepatitis B.

作者信息

Wiese Jennifer, Derian Nayiri A, Turki M'hamed, Joshi Tejas, Alsanani Ahlim, Satoskar Anjali

机构信息

Internal Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.

Gastroenterology, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.

出版信息

Cureus. 2024 Oct 1;16(10):e70619. doi: 10.7759/cureus.70619. eCollection 2024 Oct.

DOI:10.7759/cureus.70619
PMID:39483559
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11526628/
Abstract

Hepatitis B-associated glomerulonephritis (GN) has been recognized for decades. However, only a few cases of IgA nephropathy (IgAN) in a setting of rapidly progressive glomerulonephritis (RPGN) associated with chronic hepatitis B virus (HBV) have been described. Herein, we report the case of a 42-year-old Asian female with a past medical history significant for chronic HBV on entecavir, hypertension, chronic kidney disease, and newly diagnosed breast cancer, who underwent elective bilateral mastectomy and breast augmentation. Post-operatively, she developed non-oliguric acute kidney injury and proteinuria. Renal biopsy revealed active focal crescentic and necrotizing GN with IgA and C3 deposits. Systemic autoimmune-associated and other infection-related GN were ruled out. IgAN in a setting of RPGN associated with chronic HBV was suspected.

摘要

乙型肝炎相关性肾小球肾炎（GN）已被认识数十年。然而，仅有少数关于慢性乙型肝炎病毒（HBV）相关的快速进展性肾小球肾炎（RPGN）背景下的IgA肾病（IgAN）病例被描述。在此，我们报告一例42岁的亚洲女性病例，其既往病史包括因慢性HBV服用恩替卡韦、高血压、慢性肾脏病以及新诊断的乳腺癌，该患者接受了择期双侧乳房切除术和隆胸手术。术后，她出现了非少尿型急性肾损伤和蛋白尿。肾活检显示为活动性局灶性新月体性坏死性GN，伴有IgA和C3沉积。排除了系统性自身免疫相关性和其他感染相关性GN。怀疑为慢性HBV相关的RPGN背景下的IgAN。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aede/11526628/90bd6363016b/cureus-0016-00000070619-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aede/11526628/e262664e1641/cureus-0016-00000070619-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aede/11526628/546469e39f21/cureus-0016-00000070619-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aede/11526628/722318fda8ab/cureus-0016-00000070619-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aede/11526628/90bd6363016b/cureus-0016-00000070619-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aede/11526628/e262664e1641/cureus-0016-00000070619-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aede/11526628/546469e39f21/cureus-0016-00000070619-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aede/11526628/722318fda8ab/cureus-0016-00000070619-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aede/11526628/90bd6363016b/cureus-0016-00000070619-i04.jpg

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本文引用的文献

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Secondary IgA nephropathy.继发性 IgA 肾病。
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