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首页> 外文期刊>Internal medicine. >Possible IgG4-Related Kidney Disease Requiring a Differential Diagnosis of Membranous Lupus Nephritis
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Possible IgG4-Related Kidney Disease Requiring a Differential Diagnosis of Membranous Lupus Nephritis

机译：可能需要IgG4相关的肾脏疾病，需要对膜性狼疮肾炎进行鉴别诊断

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A 25-year-old woman presented with fever, arthralgia and proteinuria exhibiting leukopenia, hypocomplementemia, increased serum IgG and IgG4, and positive antinuclear and anti-double-stranded DNA antibodies. Renal biopsy revealed membranous nephropathy with tubulointerstitial nephritis. IgG subclass immunofluorescence revealed intense IgG4 expression in glomeruli, but no expression of IgG2. Observations resembled membranous lupus nephritis with tubulointerstitial nephritis; however, elevated IgG4, low titers of antinuclear and anti-double-stranded DNA antibodies, IgG4-bearing cell infiltration, and characteristic IgG subclass deposition in glomeruli prompted diagnosis of IgG4-related tubulointerstitial nephritis with membranous nephropathy. It is challenging but important to distinguish lupus nephritis from IgG4-related kidney disease.
机译：一名25岁的妇女出现发烧，关节痛和蛋白尿，表现出白细胞减少症，补体不足症，血清IgG和IgG4升高，以及抗核和抗双链DNA抗体阳性。肾活检显示膜性肾病合并肾小管间质性肾炎。 IgG亚类免疫荧光显示肾小球中强烈的IgG4表达，但没有IgG2表达。观察类似于膜性狼疮性肾炎合并肾小管间质性肾炎。然而，IgG4升高，抗核和抗双链DNA抗体滴度低，携带IgG4的细胞浸润以及肾小球中IgG特有的亚类沉积，提示诊断为IgG4相关性肾小管间质性肾炎合并膜性肾病。将狼疮性肾炎与IgG4相关的肾脏疾病区分开来具有挑战性，但很重要。

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