伴抗中性粒细胞胞质抗体阳性的儿童IgA血管炎肾炎1例  

One case of IgA vasculitis nephritis in children with positive antineutrophil cytoplasmic antibodies

作　　者：汤芳萍 陈伟[2] 李开为[3] 陈健[2] Tang Fangping;Chen Wei;Li Kaiwei;Chen Jian(School of Medicine,Wuhan University of Science and Technology,Wuhan 430070,China;Department of Nephrology,Huangshi Central Hospital of Hubei Province,Huangshi 435000,China;Department of Pediatrics,Huangshi Central Hospital of Hubei Province,Huangshi 435000,China)

机构地区：[1]武汉科技大学医学部医学院,武汉430070 [2]黄石市中心医院肾内科,黄石435000 [3]黄石市中心医院儿科,黄石435000

出　　处：《中华肾脏病杂志》2024年第12期965-967,共3页Chinese Journal of Nephrology

基　　金：湖北省自然科学基金(2023AFD020)。

摘　　要：儿童血管炎以IgA血管炎(IgA vasculitis,IgAV)较为多见,但儿童抗中性粒细胞胞质抗体(ANCA)相关性血管炎(ANCA associated vasculitis,AAV)较为罕见。该文报道1例伴ANCA阳性的儿童IgA血管炎肾炎病例,患儿临床表现符合急进性肾炎综合征,血MPO⁃ANCA强阳性,肾组织病理表现以新月体肾小球肾炎为主,伴系膜区大量IgA沉积,经过糖皮质激素、利妥昔单抗及对症治疗后患儿病情缓解。该文旨在提高临床医师对儿童血管炎肾损害诊断和治疗的认识。IgA vasculitis(IgAV)is more common in children with vasculitis,while antineu trophilcytopla smicantibodies(ANCA)associated vasculitis(AAV)in children is relatively rare.We report a case of IgA vasculitis nephritis with ANCA positive in a child.The clinical manifestations of the child were consistent with rapidly progressive nephritis syndrome,and the serum MPO-ANCA was strongly positive.Pathologically,crescentic glomerulonephritis was mainly presented,accompanied by a large amount of IgA deposition in the mesangial area.After treatment with glucocorticoids,rituximab and symptomatic treatment,the child's condition was relieved.This report aims to improve the understanding of the diagnosis and treatment of renal damage caused by vasculitis in children.

关 键 词：肾小球肾炎 IgA 血管炎 抗体 抗中性白细胞胞质 儿童 治疗 

分 类 号：R726.9[医药卫生—儿科]