Grcevska L, Polenaković M, Dzikova S, Grozdanovski R
Department of Nephrology, University Clinical Center Skopje, Macedonia.
Clin Nephrol. 1997 Nov;48(5):331-4.
A 35-year-old nephrotic man developed acute renal failure with serum creatinine to 1543 micromol/l after a month of therapy with enalapril. Renal biopsy demonstrated minimal glomerular changes with fusion of podocytes, tubular necrosis with regeneration of tubular epithelial cells, interstitial edema with focal interstitial fibrosis, and interstitial infiltration with neutrophils, eosinophils, plasma cells and mononuclear cells. Three hemodialyses were performed in the patient during the oliguric phase of the disease. Renal function was restored after withdrawal of enalapril and initiation of steroid therapy. Steroids also contributed to the improvement of the nephrotic syndrome and proteinuria decreased from maximal ranges of 27 g/l to 2.2 g/l after six months of the follow-up. Similar cases were previously described associated with captopril treatment, but not with enalapril.
一名35岁的肾病患者在接受依那普利治疗一个月后出现急性肾衰竭，血清肌酐升至1543微摩尔/升。肾活检显示肾小球变化轻微，足细胞融合，肾小管坏死伴肾小管上皮细胞再生，间质水肿伴局灶性间质纤维化，以及间质有中性粒细胞、嗜酸性粒细胞、浆细胞和单核细胞浸润。在疾病少尿期，该患者进行了三次血液透析。停用依那普利并开始使用类固醇治疗后，肾功能得以恢复。类固醇也有助于改善肾病综合征，随访6个月后蛋白尿从最高的27克/升降至2.2克/升。之前曾描述过类似病例与卡托普利治疗有关，但与依那普利无关。
