Constantin A, Laroche M, Moulinier L, Bon E, Mazières B, Cantagrel A
Rheumatology Department, Rangueil Regional Teaching Hospital, Toulouse, France.
Rev Rhum Engl Ed. 1996 Feb;63(2):141-4.
Many rheumatoid arthritis patients have renal dysfunction induced either by the drugs used to treat their joint disease or by the chronic inflammation. A case of rheumatoid arthritis with p-antineutrophil cytoplasmic antibodies and mesangial glomerulonephritis that progressed to type I membranoproliferative glomerulonephritis is reported. The glomerular abnormalities were diagnosed by two renal biopsies done at a one-year interval. Reasons for the first and second renal biopsies were renal dysfunction with hematuria and impure nephrotic syndrome, respectively. Unusual features in this case include the succession of two histologic forms of glomerular disease in a patient with rheumatoid arthritis, the correlation between p-antineutrophil cytoplasmic antibody titers and activity of the renal disease. In addition, type I membranoproliferative glomerulonephritis is exceedingly rare in rheumatoid arthritis patients.
许多类风湿性关节炎患者的肾功能障碍是由治疗关节疾病的药物或慢性炎症引起的。本文报告了一例类风湿性关节炎患者，该患者伴有抗中性粒细胞胞浆抗体和系膜增生性肾小球肾炎，并进展为I型膜增生性肾小球肾炎。通过间隔一年进行的两次肾活检诊断出肾小球异常。第一次和第二次肾活检的原因分别是伴有血尿的肾功能障碍和不纯肾病综合征。该病例的不寻常特征包括类风湿性关节炎患者中两种组织学形式的肾小球疾病的相继出现、抗中性粒细胞胞浆抗体滴度与肾脏疾病活动之间的相关性。此外，I型膜增生性肾小球肾炎在类风湿性关节炎患者中极为罕见。
