Rovang R D, Zawada E T, Santella R N, Jaqua R A, Boice J L, Welter R L
Department of Internal Medicine, University of South Dakota School of Medicine, Sioux Falls 57105, USA.
Am J Nephrol. 1997;17(1):89-92. doi: 10.1159/000169077.
The following is a case study involving a 13-year-old girl who presented initial symptoms of an upper respiratory infection. One week later she experienced a short seizure and hours later a grand mal seizure. MRI examination of the brain demonstrated multiple changing abnormal foci of increased density in white and gray matter suggestive of a vasculitic inflammatory pattern. As a result of proteinuria and red cell casts on urinalysis, a renal biopsy was performed resulting in a diagnosis of acute post-streptococcal glomerulonephritis (APSGN). We concluded on the basis of the MRI that vasculitis was secondary to APSGN. The following paper is a description of our findings in this case and a review of the literature supporting this new interpretation of CNS disease due to APSGN.
以下是一个病例研究,患者为一名13岁女孩,最初出现上呼吸道感染症状。一周后,她经历了一次短暂惊厥,数小时后又出现一次癫痫大发作。脑部MRI检查显示白质和灰质中有多个密度增加的变化异常病灶,提示血管炎性炎症模式。由于尿液分析发现蛋白尿和红细胞管型,进行了肾活检,诊断为急性链球菌感染后肾小球肾炎(APSGN)。基于MRI结果,我们得出血管炎继发于APSGN的结论。以下论文描述了我们在该病例中的发现,并对支持这种因APSGN导致中枢神经系统疾病新解释的文献进行了综述。