Sugiyama H, Makino H, Wada J, Ota K, Nagake Y, Morioka S, Yamasaki Y, Shikata K, Kashihara N, Ikeda S
Third Department of Internal Medicine, Okayama University Medical School, Japan.
Nihon Jinzo Gakkai Shi. 1993 Jun;35(6):777-82.
We made clinicopathological studies of twelve patients with rapidly progressive glomerulonephritis (RPGN) treated at our department of Okayama University Medical School Hospital for the last eight years. By immunofluorescence microscopy, seven cases were immune complex (IC) type and five were pauci immune type. By light microscopy, the mean percentage of glomeruli with crescents was seventy five, and cellular and fibro-cellular crescents were dominant in eleven cases. Combined therapy including methylprednisolone pulse or oral steroid was effective in eleven. Hemodialysis was performed in four patients with severe uremia and three of them recovered from hemodialysis. Two cases of RPGN associated with systemic lupus erythematosus died of cerebral hemorrhage. We conclude that IC type and pauci immune type RPGN have good prognosis when treated at their active stage with intensive combined therapy and with hemodialysis if necessary.
我们对过去八年在冈山大学医学院附属医院我科接受治疗的12例快速进行性肾小球肾炎(RPGN)患者进行了临床病理研究。通过免疫荧光显微镜检查,7例为免疫复合物(IC)型,5例为少免疫型。通过光学显微镜检查,有新月体形成的肾小球平均比例为75%,11例以细胞性和纤维细胞性新月体为主。包括甲泼尼龙冲击或口服类固醇的联合治疗对11例有效。4例严重尿毒症患者进行了血液透析,其中3例从血液透析中恢复。2例与系统性红斑狼疮相关的RPGN患者死于脑出血。我们得出结论,IC型和少免疫型RPGN在活动期接受强化联合治疗并在必要时进行血液透析时预后良好。