Nakayamada Tomoya, Taguchi Kensei, Natori Chikei, Nakamura Nao, Fujii Makiko, Yamashita Yuya, Ito Sakuya, Fukami Kei
Division of Nephrology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, 830-0011, Japan.
Research Institute of Medical Mass Spectrometry, Kurume University School of Medicine, Kurume, 830-0011, Japan.
CEN Case Rep. 2024 Dec 9. doi: 10.1007/s13730-024-00952-5.
Takayasu arteritis (TAK) is a systemic inflammatory condition characterized by vasculitis in mainly the aorta and their branches; however, few reports have demonstrated glomerulonephritis and subsequent nephrotic syndrome in patients with TAK. We encountered a 69-year-old woman with TAK who developed nephrotic syndrome owing to uncontrolled hypertension. Kidney biopsy demonstrated endotheliosis, aberrant proliferation of vascular smooth muscle cells, and concentric intimal hyperplasia without any clues of vasculitis. Treatment with sacubitril/valsartan reduced proteinuria and increased serum albumin without affecting renal function, which continued to suppress blood pressure and prevent recurrence of nephrotic syndrome over 2 years.
高安动脉炎（TAK）是一种全身性炎症性疾病，主要特征是主动脉及其分支的血管炎；然而，很少有报道显示TAK患者出现肾小球肾炎及随后的肾病综合征。我们遇到一名69岁的TAK女性患者，她因高血压控制不佳而发展为肾病综合征。肾活检显示内皮细胞增生、血管平滑肌细胞异常增殖和同心性内膜增生，无任何血管炎迹象。使用沙库巴曲缬沙坦治疗可减少蛋白尿并增加血清白蛋白，且不影响肾功能，在2年多的时间里持续抑制血压并预防肾病综合征复发。
