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首页> 外文期刊>CEN Case Reports >AP-VAS 2012 case report: a case of ANCA-negative crescentic glomerulonephritis complicating multiple opportunistic infections in the digestive tract
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AP-VAS 2012 case report: a case of ANCA-negative crescentic glomerulonephritis complicating multiple opportunistic infections in the digestive tract

机译：AP-VAS 2012年病例报告：ANCA阴性新月形肾小球肾炎并发消化道多发机会性感染

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摘要

Crescentic glomerulonephritis (GN) is one of the common causes of rapidly progressive glomerulonephritis (RPGN). Pauci-immune crescentic GN is usually associated with anti-neutrophil cytoplasmic antibody (ANCA). However, patients with pauci-immune crescentic GN who lack ANCAs have recently been reported. Approximately 10–30 % of patients with pauci-immune crescentic GN lack ANCAs. The clinical characteristics of patients with ANCA-negative pauci-immune crescentic GN are not entirely the same as patients with ANCA-positive GN, and this suggests that ANCA-negative and ANCA-positive pauci-immune crescentic GN might be different disease entities. We report a patient with ANCA-negative crescentic GN complicated with multiple opportunistic infections (Candida albicans, herpes simplex virus, and Cytomegalovirus) in the digestive tract during the course of immunosuppressive therapy. After antifungal and antiviral therapies including itraconazole, valaciclovir, and ganciclovir, she recovered from multiple opportunistic infections. The occurrence of comorbid opportunistic infections during the course of immunosuppressive therapy may not be rare in the elderly. However, a case of multiple opportunistic infections limited to the digestive tract is very rare.
机译：新月型肾小球肾炎（GN）是快速进行性肾小球肾炎（RPGN）的常见原因之一。缺乏免疫力的新月形GN通常与抗中性粒细胞胞浆抗体（ANCA）相关。然而，最近报道了缺乏ANCAs的免疫性新月形GN的患者。免疫力较弱的新月形GN患者中约有10-30％缺乏ANCA。 ANCA阴性的新免疫球状新月形GN患者的临床特征与ANCA阳性的GN患者并不完全相同，这表明ANCA阴性和ANCA阳性的新免疫性新月形GN患者可能是不同的疾病。我们报告了在免疫抑制治疗过程中，消化道中有ANCA阴性的新月形GN患者并发于消化道中的多种机会性感染（白色念珠菌，单纯疱疹病毒和巨细胞病毒）。在进行抗真菌和抗病毒治疗（包括伊曲康唑，伐昔洛韦和更昔洛韦）之后，她从多种机会性感染中康复。免疫抑制治疗过程中并存机会性感染的发生在老年人中可能并不罕见。然而，仅限于消化道的多种机会性感染病例很少。

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