ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2024, Vol. 33 ›› Issue (4): 389-399.DOI: 10.3969/j.issn.1006-298X.2024.04.019

• 临床集锦 • 上一篇    

神经内分泌癌继发的膜性肾病

  

  • 出版日期:2024-08-28 发布日期:2024-08-30

Membranous nephropathy secondary to metastatic neuroendocrine carcinoma

  • Online:2024-08-28 Published:2024-08-30

摘要: 老年男性患者,因“反复双下肢水肿13年,再发半月”入院,伴随原发灶未明的低分化神经内分泌癌病史2年,两次肾活检皆提示膜性肾病,13年前肾活检组织抗磷脂酶A2受体(PLA2R)荧光染色阳性,Ⅰ型血小板域蛋白7A(THSD7A)染色阴性,此次肾活检组织PLA2R染色阴性,THSD7A染色阳性,转移性腹股沟淋巴结活检组织THSD7A染色阳性,结合临床、实验室检查及病理最终诊断为神经内分泌癌继发膜性肾病(THSD7A相关),该疾病系国内首次报道。


关键词: 经内分泌癌, 继发性膜性肾病, Ⅰ型血小板域蛋白7A

Abstract: We report a case of an elderly male for the first time in China who was admitted to hospital complaining of repeated edema of both lower limbs for 13 years and recurrence for half a month. This patient had a history of poorly differentiated neuroendocrine carcinoma with unknown primary lesion for 2 years and had undergone two renal biopsies on January 22, 2009 and December 1, 2022, both of which showed membranous nephropathy and no significant difference in light microscopy, immunofluorescence and electron microscopy. The first renal biopsy tissue was positive for phospholipase A2 receptor antibody (PLA2R AB) fluorescence staining and negative for thysopermatin domain containing 7A (THSD7A) staining. The latest renal biopsy tissue was negative for PLA2R staining and positive for THSD7A staining, and the metastatic inguinal lymph node biopsy tissue was positive for THSD7A staining. The final diagnosis was membranous nephropathy secondary to neuroendocrine carcinoma (THSD7A-related) based on clinical, laboratory and pathological findings.

Key words: neuroendocrine carcinoma, secondary membranous nephropa, thythysopermatin domain containing 7A