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首页> 外文期刊>CEN Case Reports >AP-VAS 2012 case report: a case of ANCA-negative pauci-immune crescentic glomerulonephritis associated with IL-6-producing adenosquamous cell carcinoma of the lung
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AP-VAS 2012 case report: a case of ANCA-negative pauci-immune crescentic glomerulonephritis associated with IL-6-producing adenosquamous cell carcinoma of the lung

机译：AP-VAS 2012病例报告：一例ANCA阴性的古柯免疫性新月形肾小球肾炎与产生IL-6的肺腺鳞癌相关

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A 76-year-old man with lung cancer and multiple metastases was admitted for purpura and rapidly progressive glomerulonephritis. Adenosquamous cell carcinoma of the lung had been diagnosed 6 months earlier. Two anti-cancer drug regimens had no effect. At admission, his survival with his malignancy was estimated to be several months. Renal biopsy revealed pauci-immune necrotizing crescentic glomerulonephritis (CrGN). Negative results were obtained for myeloperoxidase-anti-neutrophil cytoplasmic antibody (ANCA) and proteinase-3-ANCA by enzyme-linked immunosorbent assay, and for peripheral-ANCA and cytoplasmic-ANCA by indirect immunofluorescence. He was diagnosed with ANCA-negative pauci-immune CrGN. Although steroids were initiated, the patient died of renal failure and intestinal bleeding 2 weeks later. It was later found that cancer cells were positive for interleukin (IL)-6 and that serum IL-6 levels were significantly elevated, concomitantly with increased IL-8, granulocyte-colony stimulating factor and transforming growth factor-β levels. Some kinds of lung cancer are known to produce IL-6 that activate neutrophils and are related to ANCA-associated CrGN. It appears that IL-6 can activate neutrophils in the pathogenesis of ANCA-negative pauci-immune CrGN with lung cancer. Therapy that blocks IL-6 may prove to be effective in vasculitis and cancer-related symptoms in such cases.
机译：一名患有肺癌和多发转移灶的76岁男子因紫癜和快速进行性肾小球肾炎入院。肺腺鳞状细胞癌在6个月前被诊断出。两种抗癌药物治疗无效。入院时，他的恶性肿瘤生存期估计为数月。肾活检显示新免疫性坏死性新月形肾小球肾炎（CrGN）。酶联免疫吸附法测定髓过氧化物酶抗中性粒细胞胞浆抗体（ANCA）和蛋白酶-3-ANCA的阴性结果，间接免疫荧光法测定外周ANCA和胞质ANCA的阴性结果。他被诊断患有ANCA阴性的稀疏免疫CrGN。尽管开始使用类固醇，但患者在2周后死于肾衰竭和肠出血。后来发现癌细胞对白介素（IL）-6呈阳性，并且血清IL-6水平显着升高，并伴随着IL-8，粒细胞集落刺激因子和转化生长因子-β水平升高。已知某些类型的肺癌会产生可激活中性粒细胞的IL-6，并与ANCA相关的CrGN有关。看来IL-6可以在ANCA阴性的弱免疫CrGN肺癌的发病机理中激活嗜中性粒细胞。在这种情况下，阻断IL-6的疗法可能对血管炎和癌症相关症状有效。

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