系统性红斑狼疮 IgG4 相关疾病：病例报告与综述

IF 1.1 4区医学 Q3 UROLOGY & NEPHROLOGY

Clinical nephrology Pub Date : 2024-09-01 DOI:10.5414/CN111343

Ruyi Xie, Huimin Li, Xian Wang, Xiaowei Li

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引用次数: 0

摘要

我们报告了一名 67 岁男性患者的病例，该患者饮食摄入量少且易疲劳。实验室检查显示白细胞减少，抗核抗体（ANA）阳性，抗dsDNA抗体（A-dsDNA）和抗史密斯抗体（anti-Sm）阴性，C3和C4降低，血清免疫球蛋白G（IgG）、IgG4和肌酐升高，24小时尿蛋白1.25克。随着病情恶化，复查显示血小板减少和 A-dsDNA 阳性，肾活检病理显示 IgG4 相关性肾小管间质性肾炎。最终诊断为 IgG4 相关疾病（IgG4-RD）合并系统性红斑狼疮（SLE）。经糖皮质激素（GC）联合羟氯喹（HCQ）和霉酚酸酯（MMF）治疗后，他的病情有所好转。该病例强调，IgG4-RD 和系统性红斑狼疮可能先后发生或同时存在，也可能相互转化。

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IgG4-associated disease with systemic lupus erythematosus: A case report and review.

We report a 67-year-old man who presented with poor dietary intake and fatigue. Laboratory tests showed leukopenia, antinuclear antibody (ANA) positivity, anti-dsDNA antibody (A-dsDNA) and anti-Smith antibody (anti-Sm) negativity, decreased C3 and C4, elevated serum immunoglobulin G (IgG), IgG4, and creatinine, and 1.25 g urinary protein at 24 hours. As his condition worsened, re-examination showed thrombocytopenia and A-dsDNA positivity, and renal biopsy pathology showed IgG4-related tubulointerstitial nephritis. The final diagnosis was IgG4-related disease (IgG4-RD) with systemic lupus erythematosus (SLE). His condition improved with glucocorticoid (GC) combined with hydroxychloroquine (HCQ) and mycophenolate mofetil (MMF) treatment. This case highlights that IgG4-RD and SLE may occur successively or co-exist and may convert into each other.

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来源期刊

Clinical nephrology 医学-泌尿学与肾脏学

CiteScore

2.10

自引率

9.10%

发文量

138

审稿时长

4-8 weeks

期刊介绍： Clinical Nephrology appears monthly and publishes manuscripts containing original material with emphasis on the following topics: prophylaxis, pathophysiology, immunology, diagnosis, therapy, experimental approaches and dialysis and transplantation.