ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2014, Vol. 23 ›› Issue (3): 283-288.

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遗传性卵磷脂胆固醇酰基转移酶缺乏症肾损害

  

  • 出版日期:2014-06-28 发布日期:2014-07-02

 Renal disease associated with familiar lecithin-cholesterol acyltransferase deficiency

  • Online:2014-06-28 Published:2014-07-02

摘要:

摘要 40岁女性,病程2月,临床主要表现蛋白尿,镜下血尿,肾功能正常,轻度贫血,高密度脂蛋白显著降低。患者及其二哥有鱼眼状角膜混浊。血卵磷脂胆固醇酰基转移酶(LCAT)活性明显降低。肾活检光镜肾小球基膜、系膜区广泛空泡改变,电镜下肾小球基膜、系膜区广泛空泡化,伴嗜锇性物质分布。最终诊断为遗传性LCAT缺乏症肾损害。

关键词: 卵磷脂胆固醇酰基转移酶缺乏症, 鱼眼病, 高密度脂蛋白

Abstract:

ABSTRACT A forty year-old woman presented with proteinuria and hematuria for two months. She had mild anemia, normal renal function and significantly lower high-density lipoprotein (HDL) cholesterol. Corneal greyish opacities were observed in the patient and her brother. The absence of LCAT activity was detected in this patient. Renal biopsy showed irregular thickening of the GBM and expansion of mesangial region with focal vacuolization. Electron microscopy showed glomerular epimembranous, intramembranous, subendothelial, and mesangial accumulations of extracellular lipid material with membranous profiles and granules. The final diagnosis was renal disease associated with familiar LCAT deficiency. 

Key words:  lecithin-cholesterol acyltransferase deficiency, fish-eye disease, HDL