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产科干预后发生的肾软斑症:年轻女性急性肾损伤的罕见原因。

Renal Malacoplakia Following Obstetric Intervention: A Rare Cause of Acute Kidney Injury in a Young Woman.

作者信息

Ito Letícia Miyuki, Oguma Juliana Miki, Miyahara André Kiyoshi, da Veiga Marco Aurélio Sales, Favaro Leandro, de Godoy David Wesley, da Silva Bárbara Antunes Bruno, Moura Luiz Antônio, Durão Marcelino de Souza, Rangel Érika Bevilaqua

机构信息

Paulista School of Medicina, Federal University of São Paulo, São Paulo 04038-031, SP, Brazil.

Department of Medicine, Nephrology Division, Federal University of São Paulo, São Paulo 04038-031, SP, Brazil.

出版信息

Clin Pract. 2025 Aug 3;15(8):143. doi: 10.3390/clinpract15080143.

Abstract

: Renal malacoplakia is a rare chronic granulomatous disease, often associated with immunosuppression and persistent Gram-negative infections, particularly . : We present a case involving a 31-year-old woman with hypertension, gestational diabetes, and prior uterine curettage after labor induction for preeclampsia at 23 weeks. She developed urinary sepsis post-procedure. Imaging revealed bilateral nephromegaly, while laboratory tests showed acute kidney injury (KDIGO stage III), anemia, and thrombocytopenia. Blood and urine cultures grew . Renal biopsy confirmed malacoplakia, demonstrating PAS-positive Michaelis-Gutmann bodies and Von Hansemann cells. The patient responded to prolonged antibiotic therapy and supportive care. : This case highlights the importance of considering renal malacoplakia in patients with atypical urinary tract infections and nephromegaly, particularly in obstetric settings. Histopathological confirmation is essential, and timely treatment with intracellularly active antibiotics can lead to favorable outcomes. Early diagnosis is critical to prevent irreversible renal damage.

摘要

肾软斑病是一种罕见的慢性肉芽肿性疾病,常与免疫抑制及持续性革兰阴性菌感染相关,尤其是……我们报告一例31岁女性病例,该患者有高血压、妊娠期糖尿病,曾在23周因子痫前期引产术后行刮宫术。术后发生尿脓毒症。影像学检查显示双侧肾肿大,而实验室检查显示急性肾损伤(KDIGOⅢ期)、贫血和血小板减少。血培养和尿培养生长出……肾活检证实为软斑病,可见PAS阳性的迈克尔is -古特曼小体和冯·汉塞曼细胞。患者经长期抗生素治疗及支持治疗后好转。该病例强调了在非典型尿路感染和肾肿大患者中,尤其是产科环境下,考虑肾软斑病的重要性。组织病理学确诊至关重要,使用细胞内活性抗生素及时治疗可带来良好预后。早期诊断对于预防不可逆的肾损伤至关重要。

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