ASSOCIATED FOCAL AND SEGMENTAL GLOMERULOSCLEROSIS IN THE ACQUIRED IMMUNODEFICIENCY SYNDROME
ASSOCIATED FOCAL AND SEGMENTAL GLOMERULOSCLEROSIS IN THE ACQUIRED IMMUNODEFICIENCY SYNDROME
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DOI：
10.1056/nejm198403153101101
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发表时间：
1984-01-01
影响因子：
158.5
通讯作者：
FRIEDMAN, EA
中科院分区：
文献类型：
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作者：
RAO, TKS;FILIPPONE, EJ;FRIEDMAN, EA
在 2 年时间内就诊的 92 名获得性免疫缺陷综合征 (AIDS) 患者中，9 名患有肾病综合征（尿蛋白 > 3.5 g/24 小时），2 名患有氮质血症且尿蛋白量较少。这11名患者中，5名有静脉注射海洛因成瘾史，但其余6名患者没有已知的肾病诱发因素。 9 名患者（包括 6 名非成瘾者）的肾脏疾病病程以快速进展为严重尿毒症为标志。 7 例患者的肾组织活检和 3 例尸检显示局灶性和节段性肾小球硬化，肾小球内沉积有 IgM 和 C3 [补体成分 3]。在第 11 例患者中，肾活检显示系膜基质和细胞增加，IgG 和 C3 沉积，符合轻度免疫复合物肾小球肾炎和严重间质性肾炎。因此，局部和节段性肾小球硬化可能与艾滋病有关。快速恶化为尿毒症可能是这种肾脏疾病的特征。
Of the 92 patients with the acquired immunodeficiency syndrome (AIDS) who were seen over a 2-yr period, 9 acquired the nephrotic syndrome (urinary protein > 3.5 g/24 h) and 2 had azotemia with lesser amounts of urinary protein. Of these 11 patients, 5 had a history of i.v.-heroin addiction, but in the remaining 6 there were no known predisposing factors for nephropathy. In 9 patients (including the 6 non-addicts) the course of renal disease was marked by rapid progression to severe uremia. Renal tissue examined by biopsy in 7 patients and at autopsy in 3 revealed focal and segmental glomerulosclerosis with intraglomerular deposition of IgM and C3 [complement component 3]. In the 11th patient, renal biopsy revealed an increase in mesangial matrix and cells, with deposition of IgG and C3 consistent with a mild immune-complex glomerulonephritis and severe interstitial nephritis. Thus, local and segmental glomerulosclerosis may be associated with AIDS. Rapid deterioration to uremia may characterize this renal disease.