Strobel E S, Fritschka E
Department of Internal Medicine, Freiburg University Hospital, Germany.
Clin Rheumatol. 1998;17(6):524-30. doi: 10.1007/BF01451293.
Ankylosing spondylitis (AS) can be accompanied by extraarticular manifestations in the cardiovascular, pulmonary, neurologic and renal organs. Secondary renal amyloidosis is the most common cause of renal involvement in AS (62%) followed by IgA nephropathy (30%), mesangioproliferative glomerulonephritis (5%) as well as rarely membranous nephropathy (1%), focal segmental glomerulosclerosis (1%) and focal proliferative glomeruleonephritis (1%). Treatment associated nephrotoxicity may result from non-steroidal anti-inflammatory drugs or disease modifying agents. The purpose of this paper was to alert for the possibility of renal damage in AS and to analyse the frequencies of different etiologies of renal involvement. Two typical case reports of renal involvement in AS are presented to illustrate the clinical course of such patients. Renal side effects and possible pre-existing renal diseases should be taken into account while choosing the appropriate medication for patients with AS.
强直性脊柱炎(AS)可伴有心血管、肺、神经和肾脏器官的关节外表现。继发性肾淀粉样变性是AS患者肾脏受累最常见的原因(62%),其次是IgA肾病(30%)、系膜增生性肾小球肾炎(5%),以及罕见的膜性肾病(1%)、局灶节段性肾小球硬化(1%)和局灶增生性肾小球肾炎(1%)。治疗相关的肾毒性可能由非甾体抗炎药或病情改善药物引起。本文旨在提醒注意AS患者发生肾损害的可能性,并分析肾脏受累不同病因的发生率。现呈现两例AS患者肾脏受累的典型病例报告,以说明此类患者的临床病程。在为AS患者选择合适药物时,应考虑肾脏副作用及可能已存在的肾脏疾病。