Morcamp D, Bercoff E, Ducastelle T, Godin M, Fillastre J P, Bourreille J
Ann Med Interne (Paris). 1985;136(2):109-13.
The authors report the case of a 45 year old man who had undergone a ventriculo-atrial CSF shunt procedure 5 years previously for normal pressure hydrocephalus and who had several unexplained episodes of infection over a 12 months period and has now developed a mixed nephrotic syndrome associated with a septicaemia. Corynebacterium commensale and Staphylococcus epidermis were isolated from the valve culture. Ablation of the valve resulted in clinical cure with minimal functional renal sequellae. The initial renal biopsy showed type I proliferative glomerulonephritis with subendothelial deposits of complement and immunoglobulins, which did not completely regress after 3 months' evolution. The serum complement fractions suggested activation of the alternate pathway and the possible pathogenic role of circulating immune complexes.
作者报告了一例45岁男性病例，该患者5年前因正常压力脑积水接受了脑室-心房脑脊液分流术，在12个月内发生了几次不明原因的感染，目前已发展为与败血症相关的混合性肾病综合征。从瓣膜培养物中分离出共生棒状杆菌和表皮葡萄球菌。瓣膜切除术后临床治愈，肾功能后遗症轻微。最初的肾活检显示为I型增生性肾小球肾炎，伴有补体和免疫球蛋白的内皮下沉积，3个月的病程后并未完全消退。血清补体成分提示替代途径激活以及循环免疫复合物可能的致病作用。
