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首页> 外文期刊>CEN Case Reports >A case of membranoproliferative glomerulonephritis developed over twenty years with three different findings of renal pathology
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A case of membranoproliferative glomerulonephritis developed over twenty years with three different findings of renal pathology

机译：二十年来发展为膜增生性肾小球肾炎的一例，其肾脏病理学有三个不同的发现

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摘要

A 31-year-old woman with proteinuria, hypocomplementemia, rheumatoid factor, and high serum polyclonal IgM concentration was admitted to our hospital for renal biopsy. She had a past history of two renal biopsies. When she was 12 years old, she developed proteinuria, microscopic hematuria, and hypocomplementemia. She was diagnosed as having ‘IgM nephropathy’ based on minor glomerular abnormalities as determined by light microscopy and IgM and C3 deposition in the mesangial region by immunofluorescence microscopy at the first biopsy. Despite corticosteroid treatment, her proteinuria did not improve and she discontinued regular outpatient checkups. When she was 29 years old and pregnant, she developed preeclampsia and, after delivery, a second renal biopsy was implemented. She was diagnosed as having progressed ‘IgM nephropathy’ with endotheliosis induced by preeclampsia. She was treated with angiotensin II receptor blocker and her proteinuria diminished; however, 1 year after the delivery, she developed proteinuria again, along with microscopic hematuria and hypocomplementemia. A third renal biopsy was conducted at 31 years of age and she was diagnosed as having membranoproliferative glomerulonephritis (MPGN) type I on the basis of diffuse mesangial proliferation, endocapillary hypercellularity with double contour of the capillary wall, and lobular formation in glomeruli, as determined by light microscopy. Immunofluorescence staining demonstrated deposits of C3, C4, C1q, and IgM in the mesangial region and capillary wall. She underwent corticosteroid therapy followed by normalization of urinalysis and serum complement level. Although she had initially been diagnosed with ‘IgM nephropathy’, she was finally diagnosed with secondary MPGN and was successfully treated by corticosteroid therapy.
机译：一名蛋白尿，低补体血症，类风湿因子和高血清多克隆IgM浓度的31岁妇女被送入我院进行肾脏活检。她有两次肾脏活检的病史。当她12岁时，她发展为蛋白尿，镜下血尿和补体不足。根据轻微的肾小球异常诊断为“ IgM肾病”，这是通过光学显微镜检查以及首次活检时通过免疫荧光显微镜检查发现的肾小球系膜区IgM和C3沉积所致。尽管使用了皮质类固醇激素治疗，但蛋白尿并没有改善，因此停止了常规的门诊检查。当她29岁怀孕时，她患有先兆子痫，分娩后进行了第二次肾活检。她被诊断为先兆子痫引起的内皮病发展为“ IgM肾病”。她接受了血管紧张素Ⅱ受体阻滞剂的治疗，蛋白尿减少。然而，分娩后1年，她又发展为蛋白尿，并伴有镜下血尿和低补体血症。 31岁时进行了第三次肾脏活检，根据弥散性肾小球系膜增生，毛细血管壁双重轮廓的毛细血管内膜细胞增生和肾小球小叶形成被诊断为I型膜增生性肾小球肾炎（MPGN）。通过光学显微镜。免疫荧光染色显示，C3，C4，C1q和IgM沉积在系膜区和毛细血管壁中。她接受了皮质类固醇激素治疗，随后尿液分析和血清补体水平恢复正常。尽管她最初被诊断出患有“ IgM肾病”，但最终被诊断出患有继发性MPGN，并成功接受了糖皮质激素治疗。

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  • 来源
    《CEN Case Reports》 |2013年第1期|76-83|共8页
  • 作者

    Yoshikatsu Kaneko; Kazuhiro Yoshita; Hideyuki Kabasawa; Naofumi Imai; Yumi Ito; Mitsuhiro Ueno; Shinichi Nishi; Ichiei Narita;

  • 作者单位

    Division of Clinical Nephrology and Rheumatology Niigata University Graduate School of Medical and Dental Sciences">(1);

    Division of Clinical Nephrology and Rheumatology Niigata University Graduate School of Medical and Dental Sciences">(1);

    Niigata City General Hospital">(2);

    Division of Clinical Nephrology and Rheumatology Niigata University Graduate School of Medical and Dental Sciences">(1);

    Division of Clinical Nephrology and Rheumatology Niigata University Graduate School of Medical and Dental Sciences">(1);

    University Health Center Joetsu University of Education">(3);

    Division of Nephrology and Kidney Center Kobe University Graduate School of Medicine">(4);

    Division of Clinical Nephrology and Rheumatology Niigata University Graduate School of Medical and Dental Sciences">(1);

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  • 正文语种 eng
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  • 关键词

    IgM nephropathy; Rheumatoid factor; Foam cell; Preeclampsia; Secondary MPGN;

    机译：IgM肾病;类风湿因子;泡沫细胞先兆子痫;二级MPGN;

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