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[系膜毛细血管性肾小球肾炎与类风湿关节炎。一个存在诊断和治疗问题的病例(作者译)]

[Mesangiocapillary glomerulonephritis and rheumatoid arthritis. A case with diagnostic and therapeutic questions (author's transl)].

作者信息

Bürkle P A, Tönnesmann E, Franz H E, Federlin K

出版信息

Immun Infekt. 1976 Apr;4(2):79-83.

PMID:61163
Abstract

A 34 years old white male patient suffering from a seropositive "probable" rheumatoid arthritis developed a severe hypocomplementemic mesangiocapillary glomerulnophritis. Rheumatoid factor-Latextest and Waaler-Rose-Titers and IgM have been found highly elevated in the serum. The third component of complement (C3) was markedly depressed, while the fourth component (C4) was within the normal range. The rapid progression of both diseases forced us to start an immunosuppressive drug therapy using azathioprine and steroids, 18 months after the beginning of the treatment the patient is well, has only slight proteinuria, normal levels of complement and no joint pain. The possible connections between rheumatoid arthritis and mesangiocapillary glomerulonephritis in this case as well as the therapeutic approaches are discussed.

摘要

一名34岁的白人男性患者,患有血清学阳性的“可能的”类风湿性关节炎,并发了严重的低补体血症性系膜毛细血管性肾小球肾炎。血清中类风湿因子乳胶试验、瓦勒-罗斯滴度和IgM水平显著升高。补体第三成分(C3)明显降低,而第四成分(C4)在正常范围内。两种疾病的快速进展迫使我们开始使用硫唑嘌呤和类固醇进行免疫抑制药物治疗,治疗开始18个月后,患者情况良好,仅有轻微蛋白尿,补体水平正常,且无关节疼痛。本文讨论了该病例中类风湿性关节炎与系膜毛细血管性肾小球肾炎之间可能的联系以及治疗方法。

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