IgA肾病感染甲型流感后并发急性胰腺炎1例报道及文献复习  

A case report on acute pancreatitis complicated by influenza A infection of IgA nephropathy and literature review

作　　者：徐僖梅 朱慧敏 吴挺柏[1] 朱波吕 Xu Ximei;Zhu Huimin;Wu Tingbai;Zhu Bolyu(Pediatric Department,Zhongshan People's Hospital,Zhongshan 528400,China)

机构地区：[1]中山市人民医院普通儿科,中山528400

出　　处：《国际医药卫生导报》2024年第12期2059-2062,共4页International Medicine and Health Guidance News

基　　金：广东省高水平医院建设资金资助项目。

摘　　要：免疫球蛋白A(IgA)肾病是一种常见的肾小球疾病,典型特征是肾小球系膜区IgA免疫复合物的沉积。其主要临床表现为发作性肉眼血尿和持续性镜下血尿,可伴有不同程度的蛋白尿,部分患儿表现为肾病综合征、急性肾炎综合征、急进性肾炎综合征,可合并高血压及肾功能减退。急性胰腺炎是一种以胰腺的急性炎症为特征的疾病,主要的病理过程为胰腺水肿、出血、坏死,主要临床特征为腹部剧痛、腹膜炎、休克。甲流是由甲型流感病毒感染引起的急性呼吸道传染病,临床表现为呼吸道症状,主要通过空气传播,其分型在于血凝素和神经氨酸酶表面蛋白的变化(抗原性转换和抗原性漂移),流感暴发的后续传播、持续时间以及严重程度取决于人群的易感性。这三种疾病在临床上并不少见,但同时发生在同一患者身上的情况相当罕见。本文报道了中山市人民医院1例患有IgA肾病的11岁男童感染甲流后并发急性胰腺炎,旨在进一步探讨这三种疾病之间的潜在联系。Immunoglobulin A(IgA)nephropathy is a common glomerular disease characterized by the deposition of IgA immune complexes in the glomerular mesangial regions.Its primary clinical manifestations are episodic gross hematuria and persistent microscopic hematuria,often accompanied by varying degrees of proteinuria.Some patients may present with nephrotic syndrome,acute nephritic syndrome,or rapidly progressive glomerulonephritis,and may also develop hypertension and renal function impairment.Acute pancreatitis is a condition marked by acute inflammation of the pancreas,primarily involving edema,hemorrhage,and necrosis of the pancreas,with severe abdominal pain,peritonitis,and shock as its main clinical features.Influenza A,an acute respiratory infectious disease caused by infection with the influenza A virus,is primarily airborne.Its subtypes are classified based on changes in hemagglutinin and neuraminidase surface proteins(i.e.,antigenic shift and drift),with the subsequent spread,duration,and severity of influenza outbreaks depending on the susceptibility of the population,primarily manifesting as respiratory symptoms.While these three conditions are not uncommon clinically,their concurrent occurrence in the same patient is quite rare.This article reported an 11-year-old boy with IgA nephropathy who developed acute pancreatitis following an influenza A infection in Zhongshan People's Hospital,aiming to further explore the potential connections among the three diseases.

关 键 词：IGA肾病 急性胰腺炎 甲型流感病毒 紫癜性肾炎 免疫机制 遗传 

分 类 号：R692[医药卫生—泌尿科学] R576[医药卫生—外科学]