Kidney and urinary tract involvement in kawasaki disease.
Kidney and urinary tract involvement in kawasaki disease.
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DOI：
10.1155/2013/831834
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发表时间：
2013
影响因子：
2.1
通讯作者：
Watanabe T
中科院分区：
文献类型：
--
作者：
Watanabe T
川崎是一种全身性血管炎，可导致包括肾脏和泌尿道在内的多器官损害。这些病症包括脓尿、肾前性急性肾损伤（阿基）、由肾小管间质性肾炎（TIN）引起的肾阿基、溶血性尿毒症综合征（HUS）和免疫复合物介导的肾病、与川崎休克综合征或未知原因相关的肾阿基、急性肾炎综合征（ANS）、肾病综合征（NS）、肾小管异常、成像研究中的肾异常、和肾动脉病变（动脉瘤和狭窄）。脓尿在KD中很常见，并且起源于尿道和/或肾脏。伴有阿基和肾小管异常的TIN可能是由T细胞活化引起的肾实质炎症引起的。HUS和肾动脉病变是由血管炎引起的血管内皮损伤引起的。一些ANS患者具有与免疫复合物形成相关的免疫异常。肾脏超声检查和肾动脉造影分别可在KD患者中发现肾肿大和肾实质炎性病灶。虽然KD的确切发病机制尚未完全了解，但肾血管炎、免疫复合物介导的肾损伤或T细胞免疫调节异常已被认为是肾和尿路损伤发生的可能机制。
Kawasaki disease (KD) is a systemic vasculitis and can develop multiple organ injuries including kidney and urinary tract involvement. These disorders include pyuria, prerenal acute kidney injury (AKI), renal AKI caused by tubulointerstitial nephritis (TIN), hemolytic uremic syndrome (HUS), and immune-complex mediated nephropathy, renal AKI associated with either Kawasaki disease shock syndrome or unknown causes, acute nephritic syndrome (ANS), nephrotic syndrome (NS), renal tubular abnormalities, renal abnormalities in imaging studies, and renal artery lesions (aneurysms and stenosis). Pyuria is common in KD and originates from the urethra and/or the kidney. TIN with AKI and renal tubular abnormalities probably result from renal parenchymal inflammation caused by T-cell activation. HUS and renal artery lesions are caused by vascular endothelial injuries resulting from vasculitis. Some patients with ANS have immunological abnormalities associated with immune-complex formation. Nephromegaly and renal parenchymal inflammatory foci are detected frequently in patients with KD by renal ultrasonography and renal scintigraphy, respectively. Although the precise pathogenesis of KD is not completely understood, renal vasculitis, immune-complex mediated kidney injuries, or T-cell immune-regulatory abnormalities have been proposed as possible mechanisms for the development of kidney and urinary tract injuries.