Mavratsas Vasilis C, Vu Lan, Yeh Owen L
Internal Medicine, University of Texas Medical Branch, Galveston, USA.
Cureus. 2024 Nov 7;16(11):e73233. doi: 10.7759/cureus.73233. eCollection 2024 Nov.
Rapidly progressive glomerulonephritis (RPGN) is a severe type of nephritic syndrome that involves progressive loss of kidney function and can lead to significant morbidity and mortality. RPGN has many etiologies, of which pauci-immune crescenting glomerulonephritis (PICGN) is the most common; however, patients often present with nonspecific symptoms, which can lead to a delay in diagnosis and treatment. We describe one such case that was correctly identified only after multiple clinic and hospital encounters. Following the correct diagnosis, the patient was started on induction therapy with corticosteroids and rituximab with plans for outpatient maintenance therapy. We have included a discussion of the pathogenesis, epidemiology, diagnosis and treatment of RPGN, highlighting the importance of early recognition of the disease in achieving better patient outcomes.
快速进展性肾小球肾炎（RPGN）是一种严重的肾病综合征类型，涉及肾功能的进行性丧失，并可导致显著的发病率和死亡率。RPGN有多种病因，其中寡免疫性新月体性肾小球肾炎（PICGN）最为常见；然而，患者常表现为非特异性症状，这可能导致诊断和治疗延迟。我们描述了这样一个病例，该病例在多次门诊和住院就诊后才得到正确诊断。确诊后，患者开始接受糖皮质激素和利妥昔单抗诱导治疗，并计划进行门诊维持治疗。我们还讨论了RPGN的发病机制、流行病学、诊断和治疗，强调了早期识别该疾病对改善患者预后的重要性。
