重度狼疮肾炎合并血栓性微血管病1例  

A case of lupus nephritis complicated with thrombotic microangiopathy

作　　者：刘玉秋 蒋淳 王凤梅 杨艳 王彬 张晓良[1] Liu Yuqiu;Jiang Chun;Wang Fengmei;Yang Yan;Wang Bin;Zhang Xiaoliang(Department of Nephrology,Zhong Da Hospital,School of Medicine,Southeast University,Nanjing 210009,China)

机构地区：[1]东南大学附属中大医院肾脏科东南大学医学院,南京210009

出　　处：《中华肾脏病杂志》2025年第1期58-62,共5页Chinese Journal of Nephrology

基　　金：国家自然科学基金(82060132)。

摘　　要：该文报道了1例青少年重度狼疮肾炎合并进行性溶血性贫血、血小板降低、多系统器官受累病例,患者以血肌酐持续升高伴少尿起病,通过基因检测、分子技术实现精准诊断,确诊狼疮肾炎合并血栓性微血管病。经及时采用双重滤过血浆置换、阻断B细胞靶点及补体激活靶点、补充冰冻血浆等治疗手段,患者尿量、肾功能恢复,水肿减退;尿红细胞和尿蛋白量降低,抗dsDNA抗体、补体C3和C4水平恢复正常水平。This paper reported a case of severe lupus nephritis in an adolescent with progressive hemolytic anemia,thrombocytopenia,and multiple organs involvement,in which renal damage was characterized by sustained elevation of serum creatinine and oliguria.Accurate diagnosis of lupus nephritis complicated with thrombotic microangiopathy was achieved through genetic testing and molecular technology.The use of double filtration plasmapheresis,blocking B-cell targets and complement activation targets,and supplementing frozen plasma provided more accurate,safe and effective treatment options for patients,which significantly improved prognosis.

关 键 词：狼疮肾炎 血栓性微血管病 依库珠单抗 

分 类 号：R59[医药卫生—内科学]