白塞病合并肾脏损害三例分析并文献复习

Renal involvement of Behcet′s disease: a report of 3 cases with literature review

目的分析白塞病合并肾脏病变的临床和肾脏活组织检查(简称:肾活检)组织学特点。方法分析3例白塞病患者肾脏表现的临床、实验室检查及肾脏活检表现,对相关文献进行复习并与本研究结果对比。结果3例患者出现肾脏病变时均伴有全身病变活动。2例表现为无症状蛋白尿,肾活检为肾小球病变;另1例表现为肾小管酸中毒和蛋白尿,肾脏活检为肾小管间质病变,3例均有不同程度的肾间质病变。所有3例的肾脏病变均较轻,经糖皮质激素和免疫抑制剂联合治疗后临床表现减轻。结论白塞病肾脏受累在临床上不多见,肾脏损害以蛋白尿多见。病理上肾小球、肾小管及肾间质均可以受累,而肾血管则均未累及。本研究报道的3例患者均有肾间质病变,肾脏组织学损害较轻微。

Objective To analvze the clinical features and the pathological changes of renal involvement of patients with Beheet＇s disease. Methods Three eases with definite Behcet＇s disease complicated with renal damage were reviewed retrospeetively. The related literature were reviewed. Results All 3 patients had active systemic disease when renal damage oceurred. Two patients had proteinuria and the renal biopsy demonstrated glomerular damage. One patient had proteinuria and renal tubular acidosis. However, the renal biopsy of this patient showed renal tubular damage without the involvement of glomeerli. Clinical manifestations of renal injuries subsided with the comhined treatment of cnrticosteroid and imnmunosuppressive agent. Conclusion Renal damage is relatively uncommon in Behcet＇s disease based on this report. Both glomeruli and renal tubules ran be involved. However, renal vessels were spared. All 3 cases had renal interstitial inflammatory infiltration and the prognosis is generally good. This is different from the literature where glomerular involvement is more common and severe.