ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2015, Vol. 24 ›› Issue (6): 578-581.

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Fabry病合并IgA肾病

  

  • 出版日期:2015-12-28 发布日期:2015-12-29

Coexistence of Fabry disease and IgA nephropathy

  • Online:2015-12-28 Published:2015-12-29

摘要:

青年女性,慢性病程,临床表现少~中等量蛋白尿伴少量镜下血尿,肝肾功能正常,无肾外表现,无家族史。肾活检示肾小球系膜增生性病变伴足细胞胞质大量泡沫变性,免疫荧光染色IgA沉积于肾小球系膜区,甲苯胺蓝染色见肾小球足细胞胞质内大量嗜甲苯胺蓝颗粒,电镜观察除肾小球系膜区电子致密物沉积外,足细胞胞质内可见髓样小体及斑马小体。该患者最终诊断为Fabry病合并IgA肾病。

关键词: Fabry病, IgA肾病, 肾活检

Abstract:

A 33 yearold female presented with mild to moderate proteinuria, mild hematuria, normotension, and normal renal function for 5 months. She had no extrarenal symptom or family history of Fabry disease. A renal biopsy showed mild mesangial expansion and strikingly enlarged and vacuolated podocytes. On immunofluorescence microscopy, IgA and C3 deposits were detected in mesangial areas. Semithin section stained with toluidin blue showed characteristic “blue inclusions” in podocytes. Myeloid bodies and zebra bodies were detected mainly in podocytes characteristic of Fabry disease, and dense deposits were detected in mesangial area by electron microscopy. The final diagnosis was coexistence of Fabry disease and IgA nephropathy.