Sjögren病患者的膜性肾病。

IF 1 Q4 RHEUMATOLOGY
Reumatismo Pub Date : 2025-09-17 Epub Date: 2025-05-20 DOI:10.4081/reumatismo.2025.1794
Kubra Kaynar, Şeymanur Serdar Kılıçaslan, Sevdegül Mungan, Seda Akduman, Vildan Kumcu, Nihan Yazıcı
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引用次数: 0

摘要

1930年,一位患有慢性风湿病的中年女性患者首次报道了Sjögren病(SjD)。膜性肾病(MN)是老年人肾病综合征中最常见的肾小球肾炎类型。导致继发性MN的自身免疫性疾病之一是SjD。68岁女性,病史为高血压25年,SjD 9年,抑郁情绪障碍,冠状动脉内支架置入伴周围水肿。低白蛋白血症、甲状腺功能减退、血尿、蛋白尿和白蛋白尿也被检测到。自身抗体组抗核抗体、抗ro -52抗体、抗ro / ss相关抗原A抗体、抗着丝粒抗体阳性。肾活检显示MN。抗磷脂酶A2受体抗体阴性。给予甲基强的松龙、环sporine、羟氯喹、硝苯地平、美托洛尔、缬沙坦、l -甲状腺素、乙酰水杨酸、人工泪液和氟西汀。在治疗的第一个月检测到部分缓解。然而,患者在接种了所有疫苗后,出现了猪流感感染和随后广泛的念珠菌病,尽管治疗了两性霉素B并停止了免疫抑制剂,但由于感染性休克,患者于第5个月死亡。抗pla2r抗体阴性MN是SjD的肾脏表现之一。患者预后不良是由于高SjD疾病活动性和严重的感染并发症,这是导致总死亡率的独立危险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Membranous nephropathy in a patient with Sjögren's disease.

Sjögren's disease (SjD) was first described in a middle-aged female patient with chronic rheumatism in 1930. Membranous nephropathy (MN) is the most commonly identified type of glomerulonephritis in older adults with nephrotic syndrome. One of the autoimmune diseases that causes secondary MN is SjD. A 68-year-old female patient with a medical history of 25 years of hypertension, 9 years of SjD, depressive mood disorder, and intracoronary stent placement applied with peripheral edema. Hypoalbuminemia, hypothyroidism, hematuria, proteinuria, and albuminuria were also detected. In the autoantibody panel, antinuclear antibodies, anti-Ro-52 antibody, anti-Ro/SS-related antigen A antibody, and anticentromere antibody were positive. Kidney biopsy revealed MN. Anti-phospholipase A2 receptor antibody was negative. Methylprednisolone, cyclosporine, hydroxychloroquine, nifedipine, metoprolol, valsartan, L-thyroxine, acetylsalicylic acid, artificial tear drops, and fluoxetine were administered. Partial remission was detected in the first month of treatment. However, the patient, who had all vaccinations, developed swine flu infection and subsequently widespread candidiasis, and despite amphotericin B treatment and discontinuation of immunosuppressives, died in the fifth month due to septic shock. Anti-PLA2R antibody negative MN is one of the kidney manifestations of SjD. The poor prognosis of our patient was due to high SjD disease activity and severe infectious complications, which are independent risk factors for overall mortality.

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来源期刊
Reumatismo
Reumatismo RHEUMATOLOGY-
CiteScore
2.10
自引率
7.10%
发文量
20
审稿时长
10 weeks
期刊介绍: Reumatismo is the official Journal of the Italian Society of Rheumatology (SIR). It publishes Abstracts and Proceedings of Italian Congresses and original papers concerning rheumatology. Reumatismo is published quarterly and is sent free of charge to the Members of the SIR who regularly pay the annual fee. Those who are not Members of the SIR as well as Corporations and Institutions may also subscribe to the Journal.
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