Andreoli S P
Department of Pediatrics, James Whitcomb Riley Hospital for Children, Indiana University Medical Center, Indianapolis 46202, USA.
Semin Nephrol. 1998 May;18(3):270-9.
During childhood, the kidney may be involved in several different systemic diseases including the vasculitic syndromes, collagen vascular diseases, and the thrombotic microangiopathic diseases. This article discusses three of the more common systemic disease including Henoch Schonlein Purpura (HSP), systemic lupus erythematosus (SLE), and the hemolytic uremic syndrome (HUS), which occur during childhood. Each of these diseases have important renal manifestations that may present with hematuria with or without proteinuria, hypertension, rapidly progressive glomerulonephritis, and/or with acute renal failure. The occurrence of these diseases during childhood raises lifelong concerns for the child's renal function. As in glomerulonephritis associated with SLE, reactivation of the underlying disease can result in additional renal injury, whereas late extrarenal and renal complications may be observed following HUS or nephritis associated with HSP. These diseases are not only an important cause of acquired chronic renal failure during childhood, but may also lead to end-stage renal disease or other complications that do not become apparent until adulthood. In each disease, we will review the clinical manifestations, the pathology, pathophysiology, and current management and therapy.
在儿童时期，肾脏可能会累及多种不同的全身性疾病，包括血管炎综合征、胶原血管病和血栓性微血管病。本文讨论三种较为常见的儿童期全身性疾病，即过敏性紫癜（HSP）、系统性红斑狼疮（SLE）和溶血尿毒综合征（HUS）。这些疾病均有重要的肾脏表现，可出现血尿伴或不伴蛋白尿、高血压、快速进展性肾小球肾炎和/或急性肾衰竭。儿童期发生这些疾病会使人们对患儿的肾功能产生终生担忧。如同与SLE相关的肾小球肾炎一样，基础疾病的复发可导致额外的肾损伤，而在HUS或与HSP相关的肾炎之后，可能会观察到晚期肾外和肾脏并发症。这些疾病不仅是儿童期获得性慢性肾衰竭的重要原因，还可能导致终末期肾病或其他直到成年才显现的并发症。在每种疾病中，我们将回顾其临床表现、病理、病理生理学以及当前的管理和治疗方法。
