醋氯芬酸相关的狼疮样病症及急性肾损伤  

Aceclofenac induced lupus like syndrome and acute kidney injury

作　　者：涂远茂 娄丽璇 梁少姗 谢红浪 TU Yuanmao;LOU Lixuan;LIANG Shaoshan;XIE Honglang(National Clinical Research Center of Kidney Diseases,Jinling Hospital,Nanjing University School of Medicine,Nanjing 210016,China)

机构地区：[1]东部战区总医院肾脏科国家肾脏疾病临床医学研究中心全军肾脏病研究所,南京210016

出　　处：《肾脏病与透析肾移植杂志》2020年第4期395-400,共6页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：81岁男性患者,在服用醋氯芬酸3个月(累积9。6g)后突发肾病综合征伴急性肾损伤3期,血清抗核抗体(ANA)和抗组蛋白蛋白(AHA)高滴度阳性、补体正常、抗磷酯酶A2受体(PLA2R)抗体阴性。肾活检病理提示为PLA2R阴性的膜性肾病伴中度急性肾小管间质损伤。给予糖皮质激素以及对症支持治疗后病情迅速缓解,ANA和AHA转阴。最后诊断为药物(醋氯芬酸)相关的狼疮样病症及急性肾损伤。An 81⁃years⁃old male was characterized by nephrotic syndrome with acute kidney injury(AKI)stage 3,positive serum anti⁃nuclear antibody(ANA)and anti⁃histone antibody(AHA)with high titer,normal serum complement C3 and C4,as well as negative serum anti⁃phosphatase A2 receptor(PLA2R)antibody,which were arisen abruptly after taking aceclofenac for 3 months(cumulative dose 9􀆰6g).Renal pathology suggested PLA2R negative membranous nephropathy with moderate acute tubulointerstitial injury.The patient′s condition was relieved rapidly after glucocorticoid and support treatments,as well as ANA and AHA turned negative simultaneously.The final diagnosis was aceclofenac associated lupus and AKI.

关 键 词：药物性狼疮 继发性膜性肾病 急性肾损伤 醋氯芬酸 

分 类 号：R593.24[医药卫生—内科学] R692[医药卫生—临床医学]