Nishihara G, Nakamoto M, Yasunaga C, Takeda K, Matsuo K, Urabe M, Goya T, Sakemi T
Kidney Center, Saiseikai Yahata Hospital, Kitakyushu, Japan.
Clin Nephrol. 1997 Nov;48(5):327-30.
Minimal change nephrotic syndrome (MCNS) developed in a 17-year-old female and spontaneously remitted. One month later the nephrotic syndrome relapsed. Prednisolone therapy, 60 mg/day, was started and resulted in a full remission within a week and the prednisolone dose was subsequently tapered. Seven months later, when 10 mg/day of prednisolone was being administered, she developed erythematous rash with photosensitivity and polyarthralgia without exacerbation of the nephrotic syndrome, and fulfilled four of the American College of Rheumatology criteria for classification of systemic lupus erythematosus (SLE). Avoidance of direct sunlight ameliorated the erythematous rash and the polyarthralgia disappeared even though the prednisolone dose was decreased further. This is the first reported case of SLE developed in a patient with remitting MCNS.
一名17岁女性患微小病变型肾病综合征（MCNS），后自发缓解。1个月后肾病综合征复发。开始使用泼尼松龙治疗，剂量为60毫克/天，1周内完全缓解，随后泼尼松龙剂量逐渐减少。7个月后，当泼尼松龙剂量减至10毫克/天时，她出现了红斑皮疹伴光敏性和多关节痛，肾病综合征未加重，且符合美国风湿病学会系统性红斑狼疮（SLE）分类标准中的4条。避免阳光直射使红斑皮疹有所改善，即使泼尼松龙剂量进一步降低，多关节痛也消失了。这是首例关于缓解期MCNS患者发生SLE的报道病例。
