Resolution of typical lipoprotein glomerulopathy by intensive lipid-lowering therapy
Resolution of typical lipoprotein glomerulopathy by intensive lipid-lowering therapy
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DOI：
10.1053/ajkd.2003.50016
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发表时间：
2003-01-01
影响因子：
13.2
通讯作者：
Taguma, Y
中科院分区：
文献类型：
--
作者：
Ieiri, N;Hotta, O;Taguma, Y
脂蛋白肾小球病（LPG）的特征是肾小球脂蛋白血栓，可能由异常的载脂蛋白E（apoE）组成，导致肾功能进行性下降，最终导致终末期肾衰竭。尚未建立成功的液化石油气处理方法。作者使用强化降脂治疗治疗一名患有LPG并表现出肾病综合征的36岁女性，该治疗包括非诺贝特（300 mg）、尼舍立特（750 mg）、二十碳五烯酸乙酯（1，800 mg）和普罗布考（500 mg）。治疗开始后，尿蛋白排泄显著减少，高脂血症改善;治疗开始后11个月不再检测到蛋白尿。治疗开始后11个月进行的第二次活检显示，在第一次肾活检中以弥漫性和整体方式观察到的脂蛋白血栓完全消失。这些结果表明，如果异常脂蛋白血症得到充分控制，典型的LPG可以消退。
Lipoprotein glomerulopathy (LPG), characterized by glomerular lipoprotein thrombi, presumably composed of abnormal apolipoprotein E (apoE), leads to a progressive decline in renal function and eventually results in end-stage renal failure. A successful treatment for LPG has not yet been established. The authors treated a 36-year-old woman with LPG and exhibiting a nephrotic syndrome using an intensive lipid-lowering therapy consisting of fenofibrate (300 mg), niceritrol (750 mg), ethyl-icosapentate (1,800 mg), and probucol (500 mg). After the start of treatment, a remarkable decrease in urinary protein excretion and improvement in the hyperlipidemia were obtained; proteinuria was no longer detected 11 months after the initiation of treatment. A second biopsy performed 11 months after the initiation of treatment showed the complete disappearance of the lipoprotein thrombi that had been observed in a diffuse and global manner in the first renal biopsy. These findings suggest that typical LPG could be regressed if the abnormal lipoproteinemia is controlled sufficiently.