Strauss F G, Eggleston D W
Am J Nephrol. 1985;5(5):395-7. doi: 10.1159/000166973.
We report a patient with documented IgA nephropathy in whom microscopic hematuria, proteinuria, and hypertension first occurred after placement of nickel alloy base dental crowns. Progressive proteinuria culminating in nephrotic-range proteinuria occurred parallel to increased nickel placement and dramatically resolved following nickel alloy removal. That immunologic alterations occur as a result of nickel exposure has already been suggested by the common occurrence of nickel contact dermatitis, often exacerbated by intraoral nickel placement, increased carcinogenesis in nickel refinery workers, and animal models of nickel-associated carcinogenesis. Our patient may represent an example of nickel-induced sensitization and associated IgA glomerulopathy. Further study of patients with immune-mediated glomerulopathy with attention to dental nickel exposure appears indicated.
我们报告了一名确诊为IgA肾病的患者，其镜下血尿、蛋白尿和高血压在镍合金基牙冠植入后首次出现。进行性蛋白尿最终发展为肾病范围的蛋白尿，其发生与镍摄入量增加平行，在去除镍合金后显著缓解。镍接触性皮炎的常见发生，常因口腔内镍植入而加重，镍精炼工人癌症发生率增加，以及镍相关致癌作用的动物模型，都已表明镍暴露会导致免疫改变。我们的患者可能是镍诱导的致敏和相关IgA肾小球病的一个例子。似乎有必要对免疫介导的肾小球病患者进行进一步研究，并关注牙科镍暴露情况。
