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首页> 外文期刊>BMC Nephrology >Clinico-pathological considerations in a 48-years-old female with acute kidney injury: is it lupus nephritis, ANCA-associated vasculitis or something else?
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Clinico-pathological considerations in a 48-years-old female with acute kidney injury: is it lupus nephritis, ANCA-associated vasculitis or something else?

机译：48岁女性急性肾脏损伤的临床病理考虑因素：是狼疮肾炎，ANCA相关的血管炎或其他什么？

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摘要

The value of ANCA positivity in the setting of systemic lupus erythematous and their pathogenicity remains uncertain. We report the case of a 48-year-old female with rapidly progressive kidney failure, arthro-myalgia and weight loss. Auto-immune screening showed anti-dsDNA antibodies, complement consumption and triple ANCA positivity. A first kidney biopsy done at presentation highlighted class IV-G glomerulonephritis with elective extra-capillary involvement and mainly C1q glomerular deposition at immunofluorescence study. After three months of a regimen combining steroids and cyclophosphamide, a second biopsy was performed and showed class IV-G glomerulonephritis with mainly endocapillary proliferation. This case is atypical in view of immunological profile and kidney histopathological presentation and evolution and gives rise to discussion in view of recent data on ANCA value in lupus nephritis, and suggests that different auto-immune pathways may be involved in lupus nephritis.
机译：ANCA积极性在系统性红斑狼疮的阳性和其致病性中的价值仍然不确定。我们举报了一名48岁女性的案件，伴有迅速进行的肾功能衰竭，猕猴桃和体重减轻。自身免疫筛选显示抗DSDNA抗体，补充消耗和三重ANCA积极性。在介绍中完成的第一个肾脏活检突出显示IV-G级肾小球肾炎，采用选修毛细血管受累，主要是在免疫荧光研究中的C1Q肾小球沉积。组合类固醇和环磷酰胺的方案三个月后，进行第二个活组织检查，并显示IV-G级肾小球肾炎，主要是内圆腔增殖。考虑到近期狼疮性肾炎中的ANCA值数据，这种情况鉴于免疫概况和肾组织病理学呈现和演化，这种情况是不典型的。

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