Antiglomerular basement membrane antibody type rapidly progressive glomerulonephritis with seizures: Two cases and literature review.
Antiglomerular basement membrane antibody type rapidly progressive glomerulonephritis with seizures: Two cases and literature review.
复制标题
抗胆识的基底膜抗体类型迅速进行性肾小球肾炎，癫痫发作：两例病例和文献综述。
DOI：
10.1002/iid3.1074
复制
发表时间：
2023-11
影响因子：
3.2
通讯作者：
Qiao, Yufeng
中科院分区：
文献类型：
--
作者：
Han, Chongyang;Cui, Xiangrong;Tan, Zhicheng;Li, Yafeng;Qiao, Yufeng
关键词：
急进性肾小球肾炎（Rapidly progressive glomerulonephritis，RPGN）是一种临床表现为急进性肾功能衰竭，病理表现为肾小球内新月形坏死性病变伴炎性细胞浸润的疾病。尿毒症脑病（UE）通常发生在患有急性或慢性肾衰竭的患者中。本文旨在为肾病合并癫痫发作的临床诊断和治疗提供参考。患者报告了2例抗肾小球基底膜型快速进展性肾小球肾炎合并癫痫发作。在病例1中，一名40岁女性因恶心、厌食和发热住院治疗。入院时，患者出现血清炎症指标升高、中度贫血和需要血液透析的晚期急性肾损伤。发现其血清和肾组织中的抗肾小球基底膜（GBM）抗体极高。她最终被诊断出患有抗GBM疾病。她接受了皮质类固醇冲击治疗、口服环磷酰胺和泼尼松龙以及血浆置换的联合治疗，同时继续需要维持性血液透析治疗终末期肾病。在治疗期间，她突然失明，癫痫发作，意识障碍。她被诊断为可逆性后部白质脑病综合征的磁共振成像（MRI）。经控制高血压及加强免疫抑制剂治疗后，可逆性后部白质脑病症候群迅速消退。病例2患者在GBM病的基础上也出现癫痫症状，给予与病例1相似的治疗，癫痫症状得到控制。可逆性后部白质脑病综合征，特别是当伴有脑出血时，可能导致不可逆和致命的神经系统异常，因此，肾脏科医生应了解抗GBM疾病患者可逆性后部白质脑病综合征的潜在风险。我们可以根据以前的文献讨论目前的两个案例。
Rapidly progressive glomerulonephritis (RPGN) is clinically manifestations as a rapidly progressive renal failure and pathologically as crescentic and necrotizing lesions with infiltration of inflammatory cells in the glomeruli. Uremic encephalopathy (UE) usually develops in patients who are suffering from acute or chronic renal failure. The purpose of this article is to provide reference for clinical diagnosis and treatment of renal disease complicated with seizures. Patients Two cases of anti‐glomerular basement membrane type rapidly progressive glomerulonephritis complicated with seizures were reported. In case 1, a 40‐year‐old woman was hospitalized for the treatment of nausea, anorexia, and fever. On admission, she presented with elevated serum inflammatory indicators, moderate anemia, and advanced acute kidney injury requiring hemodialysis. Her anti‐glomerular basement membrane (GBM) antibody in serum and renal tissues was found to be extremely high. She was finally diagnosed with anti‐GBM disease. She was treated with a combination of corticosteroid pulse therapy, oral cyclophosphamide and prednisolone, and plasma exchange, while continued to require maintenance hemodialysis for end‐stage kidney disease. During treatment, she suddenly suffered blindness, seizure, and consciousness disturbance. She was diagnosed as posterior reversible leukoencephalopathy syndrome by magnetic resonance imaging (MRI). The posterior reversible leukoencephalopathy syndrome subsided quickly after control of her hypertension and reinforcement of immunosuppressive treatment. In case 2, the patient also developed epileptic symptoms on the basis of GBM disease, and was given treatment similar to that of Case 1, so that the epileptic symptoms were controlled. Reversible posterior leukoencephalopathy syndrome, especially when accompanied by cerebral hemorrhage, may lead to irreversible and lethal neurological abnormalities, and nephrologists should, therefore, be aware of the potential risk of reversible posterior leukoencephalopathy syndrome in patients with anti‐GBM disease. We can discuss the current two cases in the light of the previous literature.
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DOI：
10.5005/jp-journals-10071-24492
发表时间：
2023-07
期刊：
Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine
影响因子：
--
作者：
Prasad P
通讯作者：
Prasad P
影响因子：
2.2
作者：
Moorani KN;Aziz M;Amanullah F
通讯作者：
Amanullah F
影响因子：
1.2
作者：
Raikar, Manisha;Shafiq, Asad
通讯作者：
Shafiq, Asad
DOI：
10.1056/nejmoa0910500
发表时间：
2010-07-22
期刊：
The New England journal of medicine
影响因子：
--
作者：
Pedchenko V;Bondar O;Fogo AB;Vanacore R;Voziyan P;Kitching AR;Wieslander J;Kashtan C;Borza DB;Neilson EG;Wilson CB;Hudson BG
通讯作者：
Hudson BG
影响因子：
0.8
作者：
Taniguchi，Yumeko;Hanaoka，Ryosuke
通讯作者：
Hanaoka，Ryosuke