特发性肉芽肿性肾小管间质性肾炎所致的类固醇反应性肾功能不全。
Steroid-responsive renal insufficiency due to idiopathic granulomatous tubulointerstitial nephritis.
作者信息
Okada H, Konishi K, Suzuki H, Mukai M, Sakaguchi H, Igarashi K, Saruta T
机构信息
Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.
出版信息
Am J Nephrol. 1993;13(2):164-6. doi: 10.1159/000168609.
A 26-year-old male was admitted to our hospital having suffered from subfever, sterile pyuria and renal insufficiency for 1 year. There had been no apparent hematuria/proteinuria, and evidence of infection, allergy or intoxication was not demonstrated. Open renal biopsy revealed severe tubulointerstitial changes with granuloma accompanied by neither caseous necrosis nor giant cells. Infiltrating cells mostly consisted of CD4 and CD8 T cells, and some proximal tubular cells presented MHC class II antigen. Following the negative culture of biopsied specimen for acid-fast bacilli, diagnosis of idiopathic granulomatous tubulointerstitial nephritis was made, and steroid therapy was started. Two months later, pyuria disappeared and renal function improved significantly, proving the effectiveness of steroid on idiopathic granulomatous tubulointerstitial nephritis.
一名26岁男性因低热、无菌性脓尿和肾功能不全1年入院。无明显血尿/蛋白尿，未发现感染、过敏或中毒证据。开放性肾活检显示严重的肾小管间质改变伴肉芽肿，无干酪样坏死和巨细胞。浸润细胞主要由CD4和CD8 T细胞组成，一些近端肾小管细胞表达II类主要组织相容性复合体抗原。活检标本抗酸杆菌培养阴性后，诊断为特发性肉芽肿性肾小管间质性肾炎，并开始类固醇治疗。两个月后，脓尿消失，肾功能显著改善，证明类固醇对特发性肉芽肿性肾小管间质性肾炎有效。
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