一名 17 岁女性的 IgA 肾病和狼疮性肾炎:病例报告

Kimberly Sardjono, Ita Murbani Handajaningrum
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摘要

背景:急性肾炎综合征通常表现为蛋白尿、血尿、氮质血症、红细胞增多症、少尿和高血压(PHARAOH)。肾小球的广泛炎症会导致肾小球滤过率下降,从而产生尿毒症症状,如水和盐潴留,临床表现为水肿和高血压、尿蛋白阳性、尿中出现红细胞或红细胞畸形。病例介绍:据报道,一名患有肾炎综合征的 17 岁女性患有肾炎性狼疮和 IgA 肾病。患者曾接受皮质类固醇、免疫抑制剂、降压药和利尿剂治疗,但临床和实验室检查均未发现异常。为了对患者进行明确诊断并确定肾炎综合征的类型,对他进行了活组织检查。活检结果显示了 IgA 肾病(IgAN)和狼疮肾炎的特征。结论由于出现血尿、蛋白尿、眼睑浮肿和高血压,因此怀疑是肾炎综合征。对患者的治疗是支持性和对症性的。在治疗肾炎综合征时,需要长期使用皮质类固醇作为维持疗法。在治疗过程中需要进行观察,以评估病情的改善或恶化情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
IgA Nephropathy and Lupus Nephritis in a 17-Year-Old Female: A Case Report
Background: Acute nephritic syndrome is classically presented with proteinuria, haematuria, azotemia, red blood casts, oliguria, and hypertension (PHARAOH) occurring acutely. Extensive inflammation of the glomeruli causes a decrease in the glomerular filtration rate so that it will produce uremic symptoms such as water and salt retention which will give a clinical picture of edema and hypertension, positive protein in the urine, the presence of erythrocytes or the appearance of dysmorphic erythrocytes in the urine. Case presentation: A 17 year old female with nephritic syndrome is reported to have nephritic lupus and IgA nephropathy. He has been treated with corticosteroids, immunosuppressants, antihypertensives, and also diuretics followed by progress of clinical and laboratory conditions. Biopsy has been performed to provide a definitive diagnosis in the patient and determine the type of nephritic syndrome experienced. The biopsy showed features of IgA nephropathy (IgAN) and lupus nephritis. Conclusion: Nephritic syndrome has been suspected due to the presence of haematuria, proteinuria, eyelid swelling, and hypertension. The management given to patients is supportive and symptomatic. Long-term administration of corticosteroids is needed in the treatment of nephritic syndrome as a maintenance therapy. Observation during treatment is needed to assess improvement or worsening of the disease experienced.
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