Hsu Y H, Ng Y Y, Yang A H, Chen T W, Huang T P
Department of Medicine, Veterans General Hospital-Taipei, Taiwan, ROC.
Zhonghua Yi Xue Za Zhi (Taipei). 1998 May;61(5):301-5.
Acute poststreptococcal glomerulonephritis (PSGN) is quite rare in the elderly population. It is very difficult to recognize because the initial symptoms are similar to those of more common diseases of this age group. Compared with younger patients, elderly patients with PSGN tend to have a high incidence of renal function impairment and anuria or prolonged oliguria. Recovery from acute PSGN in the elderly is less predictable than in children and younger adults, especially when associated with severe impairment of renal function. We present the case of an elderly patient with PSGN, who had a skin infection of the face and anuria on admission. Percutaneous left renal biopsy was performed in the initial hospitalization period and in the recovery phase of the disease. Renal function recovered within two months. However, increased urinary white blood cell sediments with normal serum creatinine concentrations persisted in the successive three years of follow-up. Renal biopsy was repeated and showed evidence of focal segmental glomerulosclerosis.
急性链球菌感染后肾小球肾炎（PSGN）在老年人群中相当罕见。由于其初始症状与该年龄组更常见疾病的症状相似，因此很难识别。与年轻患者相比，老年PSGN患者肾功能损害、无尿或少尿延长的发生率往往较高。老年急性PSGN的恢复情况比儿童和年轻成年人更难预测，尤其是当伴有严重肾功能损害时。我们报告一例老年PSGN患者，入院时面部皮肤感染且无尿。在疾病的初始住院期和恢复期进行了经皮左肾活检。肾功能在两个月内恢复。然而，在连续三年的随访中，血清肌酐浓度正常但尿白细胞沉渣增加持续存在。再次进行肾活检，显示有局灶节段性肾小球硬化的证据。
