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.
HU Wenhui
,
ZHANG Wei
,
JU Hongge
. ANCA-associated vasculitis with membranous nephropathy with subacute tubulointerstitial injury:a case report[J]. Journal of Baotou Medical College, 2022
, 38(10)
: 86
-90
.
DOI: 10.16833/j.cnki.jbmc.2022.10.017
[1] 葛益飞, 杨光, 袁杨刚, 等.髓过氧化物酶抗中性粒细胞胞质抗体相关性肾小球肾炎患者的临床病理特征及肾脏预后分析[J].中华肾脏病杂志, 2021, 37(8):647-654.
[2] 鲁芳草.IgA肾病补体C3、IgG、IgM肾脏沉积及其病理相关性的探讨[D].昆明:昆明医科大学, 2021.
[3] 朱文博, 黄琳琳, 王娟, 等.补体旁路途径在抗中性粒细胞胞浆抗体相关性血管炎中的作用及研究进展[J].内科急危重症杂志, 2021, 27(2):94-97.
[4] Kanahara K, Yorioka N, Nakamura C, et al.Myeloperoxidase-antineutrophil cytoplasmic antibody-associated glomerulonephritis with membranous nephropathy in remission[J].Intern Med, 1997, 36(11):841-846.
[5] 禹丹, 张军军, 王旭童, 等.抗中性粒细胞胞质抗体相关性新月体肾炎合并抗肾小球基底膜抗体阳性和膜性肾病一例[J].中华肾脏病杂志, 2020, 36(10):775-778.
[6] Bulanov N, Chebotareva NV, Novikov PI, et al.Role of tubulointerstitial injury in ANCA-associated vasculitis is underestimated[J].Ann Rheum Dis, 2019, 78(10):e111.
[7] 董蕾, 张恬静, 代维, 等.抗中性粒细胞胞浆抗体相关性血管炎表现为肾小管间质性肾炎1例并文献复习[J].内科急危重症杂志, 2021, 27(5):434-437.
[8] 郭维康, 刁宗礼, 刘文虎.原发性膜性肾病合并肾小管间质损伤的特征分析[J].临床和实验医学杂志, 2019, 18(06):598-601.
[9] 罗杰, 陈小青, 杨枫, 等.血浆置换治疗ANCA相关性血管炎严重肾损害效果观察[J].人民军医, 2021, 64(7):630-632, 653.
[10] 何旭, 夏正坤.伴器官损害或威胁生命的ANCA相关性血管炎的治疗进展及挑战[J].中国全科医学, 2021, 24(23):2891-2897.
