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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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摘要

A 25-year-old woman presented with fever, arthralgia and proteinuria exhibiting leukopenia, hypocomple-mentemia, increased serum IgG and IgG4, and positive antinuclear and anti-double-stranded DNA antibodies. Renal biopsy revealed membranous nephropathy with tubulointerstitial nephritis. IgG subclass immunofluo-rescence 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，精神不全症，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。但是，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特征性IgG亚类沉积，提示诊断为IgG4相关性肾小管间质性肾炎伴膜性肾病。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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