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首页> 外文期刊>CEN Case Reports >Lupus nephritis class I accompanied by tubulointerstitial nephritis with marked T-lymphocyte infiltration in an HTLV-1 positive patient
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Lupus nephritis class I accompanied by tubulointerstitial nephritis with marked T-lymphocyte infiltration in an HTLV-1 positive patient

机译：HTLV-1阳性患者的I类狼疮性肾炎伴有肾小管间质性肾炎伴T淋巴细胞明显浸润

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摘要

We herein describe the case of a 40-year-old Japanese male who was admitted to our hospital because of a continuous remittent fever lasting 1 month. He fulfilled the items of the classification criteria for the diagnosis of systemic lupus erythematosus (SLE). The administration of 20 mg per day of oral prednisolone completely diminished his clinical symptoms. However, his renal biopsy performed 1 day after the admission showed marked pathognomonic characteristics. Not only did his glomeruli show class I lupus nephritis with mesangial depositions of IgG, IgA, C3, and C1q, but also tubulointerstitial nephritis with marked T-lymphocyte infiltration. These infiltrated T cells partly had nuclear atypia. The patient was positive for human T cell leukemia virus type 1 (HTLV-1) antibodies. Furthermore, clonal rearrangements of T cell receptor-gamma chain gene was detected in the DNA extracted from his kidney sections by the polymerase chain reaction (PCR) method. A second renal biopsy 6 months after the prednisolone treatment showed that the infiltrating T lymphocytes had markedly diminished. This is the first case report of lupus nephritis class I with tubulointerstitial nephritis, which might include oncogenic T lymphocytes, in an HTLV-1 positive patient.
机译：我们在此描述了一名40岁的日本男性患者，该患者因持续1个月的持续性发烧入院。他符合诊断系统性红斑狼疮（SLE）的分类标准。每天口服20 mg泼尼松龙可完全减轻他的临床症状。但是，入院后1天进行的肾脏活检显示出明显的病理学特征。他的肾小球不仅显示出具有IgG，IgA，C3和C1q的肾小球膜沉积的I类狼疮肾炎，而且还表现出具有明显的T淋巴细胞浸润的肾小管间质性肾炎。这些浸润的T细胞部分具有核非典型性。该患者的1型人类T细胞白血病病毒（HTLV-1）抗体呈阳性。此外，通过聚合酶链反应（PCR）方法在从其肾脏切片提取的DNA中检测到T细胞受体-γ链基因的克隆重排。泼尼松龙治疗后6个月进行的第二次肾脏活检显示浸润的T淋巴细胞明显减少。这是HTLV-1阳性患者中首例I型狼疮性肾炎合并肾小管间质性肾炎，其中可能包括致癌性T淋巴细胞。

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