IgA肾病合并抗肾小球基底膜病病例报告并文献复习  

One case report of IgA nephropathy complicated with anti-glomerular basement membrane disease and literature review

作　　者：尚伟锋 王迪[1] 葛树旺[1] 郭水明[1] 徐钢[1] 韩敏[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院,武汉430030

出　　处：《内科急危重症杂志》2015年第1期40-43,共4页Journal of Critical Care In Internal Medicine

基　　金：国家自然科学基金面上项目(No:81370798);国家自然科学基金青年基金(No:81100485);留学回国人员科研启动基金教外司留(2011)1568号

摘　　要：目的:探讨IgA肾病合并抗肾小球基底膜(GBM)病的临床表现、诊断、治疗及预后。方法:回顾性分析我院1例IgA肾病合并抗GBM病患者的临床资料,并对相关文献进行复习。结果:以肉眼血尿和进行性升高血肌酐为主要表现,既往肾活检示IgA肾病,此次入院查抗GBM阳性,考虑IgA合并抗GBM病,给予激素免疫抑制剂冲击治疗、血浆置换、规律透析治疗,但是肾功能无明显恢复。结论:IgA肾病和抗GBM病均是免疫复合物相关性疾病,两者可同时出现,及早发现、及早诊治,可有助于挽救患者的肾脏功能。Objective： To explore the clinical manifestation,diagnosis,treatment and prognosis of IgA nephropathy complicated with anti-glomerular basement membrane（ GBM） disease. Methods： The clinical data of one case of IgA nephropathy complicated with anti-GBM disease was analyzed retrospectively,and the related literatures were reviewed. Results： Gross hematuria and progressive elevation of serum creatinine was the patient＇s manifestation,and renal biopsy showed IgA nephropathy last year. Anti-GBM antibody was positive when the patient was admitted this time,therefore,the patient was considered as IgA nephropathy complicated with anti-GBM disease. The patient was treated with high doses of glucocorticoids,cyclophosphamide,plasma exchange and regular dialysis,but the renal function was not improved significantly. Conclusions： IgA nephropathy and anti-GBM disease are immune complex-mediated diseases,and both of them can present at the same time. Early detection,diagnosis and treatment may help to save patient＇s renal function.

关 键 词：抗GBM病 IGA肾病 诊断 治疗 

分 类 号：R692.3[医药卫生—泌尿科学]