Kobayashi S, Ikeda T, Okada H, Suzuki Y, Ishii M, Ohtake T, Oda T, Hishida A
Department of Medicine, NTT Izu Teishin Hospital, Shizuoka, Japan.
Am J Nephrol. 1995;15(4):356-60. doi: 10.1159/000168864.
We report here a case of type 1 mesangiocapillary glomerulonephritis as well as a case of mesangial proliferative glomerulonephritis associated with streptococcal skin infection superimposed on atopic dermatitis. Both were endemic occurrences of postinfectious glomerulonephritis developed after repeated dirty-skin treatments for atopic dermatitis performed by unauthorized individuals under unsanitary conditions. Of 20 patients who were similarly treated and subsequently admitted to our hospital because of skin infection and fever, 8 (40%) showed urinary abnormalities. Four patients had renal dysfunction with acute nephritic onset. Almost all showed a decrease in CH50 values and an increase in levels of antistreptolysin O and IgE. In the 2 cases presented here, the disease eventually regressed in association with improvement of the skin infection. Although the occurrence of postinfectious glomerulonephritis has recently become uncommon, we must take care to note urinary abnormalities as early as possible in order to prevent the progression of glomerulonephritis.
我们在此报告1例I型系膜毛细血管性肾小球肾炎以及1例叠加于特应性皮炎之上的、与链球菌皮肤感染相关的系膜增生性肾小球肾炎。这两例均为在不卫生条件下由未经授权的人员对特应性皮炎进行反复不清洁皮肤治疗后发生的感染后肾小球肾炎的地方性病例。在因皮肤感染和发热而接受类似治疗并随后入住我院的20例患者中，8例（40%）出现尿液异常。4例患者出现急性肾炎发作伴肾功能不全。几乎所有患者的CH50值均降低，抗链球菌溶血素O和IgE水平升高。在此呈现的2例病例中，疾病最终随着皮肤感染的改善而消退。尽管感染后肾小球肾炎的发生近来已不常见，但我们必须注意尽早发现尿液异常，以防止肾小球肾炎进展。
