肾移植术后脂蛋白肾病复发  

Recurrent lipoprotein glomerulopathy after renal transplantation

作　　者：董建华 倪雪峰 文吉秋 葛永纯 DONG Jianhua;NI Xuefeng;Wen Jiqiu;GE Yongchun(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,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》2022年第5期494-500,共7页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：江苏省自然科学基金面上项目(BK20201235)军队卫勤保障能力创新与生成专项(21WQ038)。

摘　　要：40岁男性患者,2004年自体肾活检(两次)均符合“脂蛋白肾病”,肾移植术后5年出现蛋白尿、血清肌酐升高,血载脂蛋白E(ApoE)高,肾活检示移植肾脂蛋白肾病,ApoE基因突变(p.L162-K164del),同时携带ANLN_(R39X)突变基因,诊断为移植肾脂蛋白肾病复发,予9次双重血浆置换联合非诺贝特治疗后,血ApoE水平下降,重复肾活检肾小球毛细血管袢脂蛋白栓子未消失。A 40-year-old male patient presented with the underlying disease lipoprotein nephropathy.Five years after renal transplantation,he developed proteinuria,elevated serum creatinine,and high serum apoE,and renal biopsy showed graft lipoprotein nephropathy.Five years after renal transplantation,proteinuria,serum creatinine and ApoE were elevated,and renal biopsy showed graft lipoprotein nephropathy.The mutant type of ApoE gene was P.L162-K164del.Patient also carries ANLN_(R39X) gene.Graft lipoprotein nephropathy is considered.After 9 treatment with double plasmoplasty combined with fenofibrate,ApoE levels decreased.However,lipoprotein emboli in the glomerular capillary loops did not disappear after repeated renal biopsy.

关 键 词：脂蛋白肾病 载脂蛋白E 肾移植术后 双重血浆置换 

分 类 号：R699.2[医药卫生—泌尿科学]