Okada K, Okamoto Y, Kagami S, Funai M, Morimoto Y, Yasutomo K, Kuroda Y
Department of Pediatrics, School of Medicine, University of Tokushima, Japan.
Am J Nephrol. 1995;15(4):337-42. doi: 10.1159/000168860.
Acute interstitial nephritis (AIN) and uveitis of unknown etiology developed in a 15-year-old girl. Symptoms and urinary abnormalities improved spontaneously but moderate renal dysfunction and anterior uveitis persisted. A repeat biopsy performed 2 years later showed focal tubulointerstitial changes, while bone marrow examination revealed granulomas. Simultaneously, antineutrophil cytoplasmic antibodies (ANCA) were detected, and decreases in T cell population and lymphocyte function were found. These immunological abnormalities normalized in parallel with clinical improvement with corticosteroid therapy, strongly suggesting that in some patients autoimmune disorders contribute to the pathogenesis of the disease.
一名15岁女孩出现了病因不明的急性间质性肾炎（AIN）和葡萄膜炎。症状及尿液异常自行改善，但中度肾功能不全和前葡萄膜炎持续存在。2年后再次进行活检显示局灶性肾小管间质改变，而骨髓检查发现肉芽肿。同时，检测到抗中性粒细胞胞浆抗体（ANCA），并发现T细胞群体及淋巴细胞功能下降。这些免疫异常随着皮质类固醇治疗临床症状的改善而恢复正常，强烈提示在某些患者中自身免疫性疾病参与了该病的发病机制。
