ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2022, Vol. 31 ›› Issue (5): 494-500.DOI: 10.3969/j.issn.1006-298X.2022.05.020

• • 上一篇    

肾移植术后脂蛋白肾病复发

  

  • 出版日期:2022-10-28 发布日期:2022-10-22

Recurrent lipoprotein glomerulopathy after renal transplantation

  • Online:2022-10-28 Published:2022-10-22

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ANLNR39X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。


关键词: 脂蛋白肾病载, 脂蛋白E, 肾移植术后, 双重血浆置换

Abstract: 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 ANLNR39X 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.


Key words: lipoprotein glomerulopathy, apolipoprotein E, renal transplantation, double filtration plasmapheresis