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一名患有巨大肾肿物的患者因IgA肾病导致快速进展性肾小球肾炎。

Rapidly Progressive Glomerulonephritis Due to IgA Nephropathy in a Patient With a Large Renal Mass.

作者信息

Shi David, Ghias Mona, Bogdansky Kevin, Haris Asif

机构信息

Internal Medicine, West Virginia University, Morgantown, USA.

Nephrology, West Virginia University, Morgantown, USA.

出版信息

Cureus. 2024 Dec 19;16(12):e76015. doi: 10.7759/cureus.76015. eCollection 2024 Dec.

Abstract

IgA nephropathy (IgAN) is a common primary glomerulonephritis characterized by the deposition of IgA immune complexes within the glomerular mesangium. IgAN can present with a wide range of clinical manifestations, ranging from asymptomatic hematuria to severe renal disease. This case describes a 67-year-old woman with a history of diabetes mellitus, hypertension, and obesity who presented with acute kidney injury and clinical manifestations of nephrotic syndrome. A renal biopsy confirmed the diagnosis of IgAN. Additionally, imaging studies revealed a large, complex renal mass, raising concerns for renal cell carcinoma. The IgAN was treated with high-dose corticosteroids; however, the patient opted for active surveillance of the renal mass rather than surgical intervention. This case highlights the complex clinical presentation of IgAN and the challenges associated with managing patients with both IgAN and renal mass.

摘要

IgA 肾病(IgAN)是一种常见的原发性肾小球肾炎,其特征是 IgA 免疫复合物在肾小球系膜内沉积。IgAN 可表现出广泛的临床表现,从无症状血尿到严重肾病不等。本病例描述了一名 67 岁女性,有糖尿病、高血压和肥胖病史,出现急性肾损伤及肾病综合征的临床表现。肾活检确诊为 IgAN。此外,影像学检查发现一个巨大、复杂的肾肿物,引发了对肾细胞癌的担忧。IgAN 采用大剂量皮质类固醇治疗;然而,患者选择对肾肿物进行主动监测而非手术干预。本病例突出了 IgAN 复杂的临床表现以及管理同时患有 IgAN 和肾肿物患者所面临的挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a97/11743532/ae921cc9dda5/cureus-0016-00000076015-i01.jpg

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