Geary D, Thorner P, Arbus G S, Baumal R
Clin Nephrol. 1985 May;23(5):258-64.
Two children with nephrotic syndrome are described whose clinical course, initial response to steroids, and renal biopsies were consistent with a diagnosis of minimal lesion disease (MLD). Both children subsequently became resistant to steroids and repeat renal biopsies 7 and 8 years after initial biopsies showed membranous glomerulonephropathy (MGN). Explanations are suggested which may account for the occurrence of MLD followed by MGN in a single patient. These cases illustrate the necessity of performing repeat renal biopsies in patients with nephrotic syndrome if the clinical behavior and response to steroids are not typical for MLD.
本文描述了两名肾病综合征患儿，其临床病程、对类固醇的初始反应以及肾活检结果均符合微小病变病（MLD）的诊断。两名患儿随后均对类固醇产生耐药，初次活检7年和8年后重复肾活检显示为膜性肾小球肾病（MGN）。文中提出了一些解释，可能说明单一患者中为何会先出现MLD，随后又出现MGN。这些病例表明，如果肾病综合征患者的临床行为和对类固醇的反应不符合MLD的典型表现，那么对其进行重复肾活检是必要的。
