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 (1): 92-96.DOI: 10.3969/j.issn.1006-298X.2024.01.018

• 临床集锦 • 上一篇    

表现为新月体性肾小球肾炎的纤维性肾小球病

  

  • 出版日期:2024-02-28 发布日期:2024-02-27

Fibrillary glomerulonephritis accompany with crescentic glomerulonephritis 

  • Online:2024-02-28 Published:2024-02-27

摘要: 34岁女性患者,临床表现为水肿、高血压、大量蛋白尿、镜下血尿、低蛋白血症、血清肌酐升高。肾活检病理光镜示大量新月体形成伴袢坏死,电镜示上皮下、基膜内及系膜区杂乱分布的纤维样结构(直径12~30 nm)沉积,肾小球免疫组化染色DNAJ热休克蛋白家族成员B9(DNAJB9)阳性,诊断为DNAJB9相关纤维性肾小球病、新月体性肾小球肾炎。给予利妥昔单抗、吗替麦考酚酯、糖皮质激素等治疗,获得了较好的临床疗效。


关键词: 利妥昔单抗, 新月体性肾小球肾炎, DNAJ热休克蛋白家族成员B9相关纤维性肾小球病

Abstract: TThe clinical manifestations of a 34-year-old female we reported were edema, hypertension, massive proteinuria, microscopic hematuria, hypoalbuminemia and elevated creatinine. Renal biopsy revealed the formation of a large number of crescents with necrosis under the light microscope, and the deposition of fibrous structures with a diameter of 12-30nm in the subepithelial, basement membrane, and mesangial areas under the electron microscope. Immunohistochemical staining of the glomerulus showed positive staining for DNAJ heat shock protein family member B9 (DNAJB9), indicating a diagnosis of DNAJB9 related fibrillary glomerulonephritis (FGN). The treatment with rituximab, mycophenolate mofetil, and glucocorticoids has achieved good clinical efficacy.


Key words: rituximab, crescentic glomerulonephritis, DNAJB9 related fibrillary glomerulonephritis