ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2021, Vol. 30 ›› Issue (4): 394-398.DOI: 10.3969/j.issn.1006298X.2021.04.019

• • 上一篇    

X连锁无丙种球蛋白血症合并膜增生性肾小球肾炎

  

  • 出版日期:2021-08-28 发布日期:2021-08-17

X-linked agammaglobulinemia with membranoproliferative glomerulonephritis

  • Online:2021-08-28 Published:2021-08-17

摘要: 本文在国内首次报道1例青少年男性,因尿检异常伴血压升高入院。入院查血白蛋白正常,球蛋白低(14g/L),血IgG、IgM、IgA偏低,外周血CD19+B细胞显著降低(8个/μl,<2%),基因检测提示X染色体BTK基因错义突变(c.82C>T,p.R28C),患者为半合子突变,母亲为该致病基因携带者;肾穿刺活检提示膜增生性肾小球肾炎(MPGN)。诊断为X连锁无丙种球蛋白血症合并MPGN。给予血管紧张素Ⅱ受体拮抗剂治疗后尿检改善。


关键词: X连锁无丙种球蛋白血症, BTK基因, 膜增生性肾小球肾炎, 遗传性疾病

Abstract: We report a case of adolescent male who was admitted to hospital due to proteinuria with microscopic hematuria and hypertension. On admission,serum albumin was normal,but globulin was as low as 14 g/L. Serum IgG,IgM and IgA levels were low and peripheral blood CD19+ B cells were significantly decreased (8/μl,<2%).Whole exome sequencing indicated that the Xchromosome BTK gene had a missense mutation (C.82c>T,p.R28C).The patient was a hemizygote mutation and his mother who was a carrier of the BTK gene.Renal biopsy revealed membranoproliferative glomerulonephritis.The final diagnosis was Xlinked agammaglobulinemia complicated with MPGN.This is the first case reported in China.Proteinuria and hematuria improved after angiotensin Ⅱ receptor antagonist treatment.


Key words: X-linked agammaglobulinemia, BTK gene, membranoproliferative glomerulonephritis, genetic disorder