Walker P D, Deeves E C, Sahba G, Wallin J D, O'Neill W M
Am J Med. 1984 Jun;76(6):1106-12. doi: 10.1016/0002-9343(84)90866-0.
A 37-year-old man presented with biopsy-proved rapidly progressive glomerulonephritis and a strongly positive fluorescent treponemal antibody result. The patient was treated with hemodialysis, plasmapheresis, methylprednisolone, and penicillin, with rapid improvement and stabilization of renal function. Antibody was eluted from the frozen renal tissue and demonstrated a strongly positive reaction to the treponemal antigen when used in the fluorescent treponemal antibody test. In addition, when specific rabbit antitreponemal antiserum was applied to the frozen renal sections, there was a strongly positive reaction. Although syphilis has been associated with membranous glomerulopathy and post-infectious glomerulonephritis, this appears to be the first case of latent syphilis in which rapidly progressive glomerulonephritis has been identified. The presence within the glomeruli of treponemal antigen and antitreponemal antibody supports the association of these two entities.
一名37岁男性患者，经活检证实患有快速进展性肾小球肾炎，荧光密螺旋体抗体检测结果呈强阳性。该患者接受了血液透析、血浆置换、甲泼尼龙和青霉素治疗，肾功能迅速改善并稳定。从冷冻肾组织中洗脱抗体，并在荧光密螺旋体抗体检测中对密螺旋体抗原呈强阳性反应。此外，当将特异性兔抗密螺旋体抗血清应用于冷冻肾切片时，出现强阳性反应。虽然梅毒与膜性肾小球病和感染后肾小球肾炎有关，但这似乎是首例确诊为快速进展性肾小球肾炎的潜伏梅毒病例。肾小球内存在密螺旋体抗原和抗密螺旋体抗体支持了这两种情况之间的关联。
