Soubrier M, Deteix P, Derray G, Dubost J J, Sauvezie B, Chapman A, Bussière J L
Service de rhumatologie, Hôpital G. Montpied, Clermont-Ferrand.
Nephrologie. 1994;15(5):335-8.
The authors report four cases of POEMS Syndrome with renal involvement. Two had renal failure and mild proteinuria. The two others had hyporeninemic hypoaldosteronism with type IV renal tubular acidosis in the first and hyperkalemia alone in the second. In the two cases, renal biopsy showed mesangial proliferation. Evolution was favourable when the plasma cell proliferation could be checked. In POEMS pathophysiology of renal involvement remains unknown. Soluble factor(s) produced by plasma cells may be responsible for most signs and symptoms perhaps as a result of increased vascular permeability.
作者报告了4例伴有肾脏受累的POEMS综合征病例。其中2例出现肾衰竭和轻度蛋白尿。另外2例,1例为低肾素性低醛固酮血症合并IV型肾小管酸中毒,另1例仅出现高钾血症。这2例患者的肾活检均显示系膜增生。当浆细胞增殖得到控制时,病情转归良好。在POEMS综合征中,肾脏受累的病理生理学机制尚不清楚。浆细胞产生的可溶性因子可能是导致大多数体征和症状的原因,这可能是血管通透性增加的结果。