肺恶性肿瘤伴多发转移患者发生IgG4相关肾病合并膜性肾病1例

IgG4-related kidney disease complicated with membranous nephropathy in one patient with multiple metastatic lung malignancies

本文报告1例以肾病综合征为首发表现,较为罕见的IgG4相关性肾病的诊治过程。患者男性,62岁,以双下肢水肿、泡沫尿为主要表现,既往有"肺恶性肿瘤史伴脑、淋巴结转移"病史。入院检测IgG4升高及肾小球滤过率下降,行肾穿刺活检病理考虑为膜性肾病,且合并IgG4相关性肾小管间质性肾炎。通过小剂量激素联合利妥昔单抗治疗后,随访9个月患者部分缓解且肿瘤无复发。

Here we report the diagnosis and treatment of a rare IgG4-related kidney disease with nephrotic syndrome as the first manifestation.A 62-year-old male patient,presented with edema in both lower limbs and foam urine,had a history of"lung malignant tumor with brain and lymph node metastasis".The increase of IgG4 and decrease of glomerular filtration rate were detected at admission,and the pathological consideration of renal biopsy was membranous nephropathy with IgG4-related tubulointerstitial nephritis.After the combination of low-dose glucocorticoids therapy and rituximab treatment,the patient showed good prognosis in a 9 month follow-up.