ANCA相关性血管炎合并膜性肾病伴亚急性肾小管间质损伤1例

ANCA-associated vasculitis with membranous nephropathy with subacute tubulointerstitial injury:a case report

目的:探讨抗中性粒细胞胞浆抗体(ANCA)相关性血管炎(AAV)合并膜性肾病(MN)伴亚急性肾小管间质损伤患者的临床病理特征及诊疗过程,增加对此类疾病的认识,减少漏诊误诊,为治疗提供线索。方法:报道1例以血肌酐升高为特点,无其他特征性临床表现女性患者的诊疗经过,回顾性分析AAV所致肾病、MN、肾小管间质损伤机制与联系及治疗方案的相关文献报道。结果:经积极治疗,患者尿蛋白减少,肾功能好转,病情平稳后出院。结论:此类疾病少见,发病机制不明确,易被忽略,且病情进展快,预后差,需及早明确诊断并进行治疗,避免病情进一步加重。

Objective:to investigate the clinicopathological features,diagnosis and treatment of antineutrophil cytoplasmic antibody(ANCA)associated vasculitis(AAV)with membranous nephropathy(MN)with subacute tubulointerstitial injury,so as to increase the understanding of these diseases,reduce missed diagnosis and misdiagnosis,and provide clues for treatment.Methods:the diagnosis and treatment of a female patient with elevated serum creatinine without other characteristic clinical manifestations was reported,and the mechanism,relationship and treatment of nephropathy,MN and renal tubulointerstitial injury caused by AAV were analyzed retrospectively.Results:after active treatment,the patient was discharged from hospital after active treatment.Conclusion:this kind of disease is rare,the pathogenesis is not clear,easy to be ignored,the disease progress is rapid,the prognosis is poor,it is necessary to make a clear diagnosis and treatment as soon as possible to avoid further aggravation of the disease.