Pattern of double glomerulopathy in children
Pattern of double glomerulopathy in children
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DOI：
10.1007/s00467-006-0342-9
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发表时间：
2007-04-01
影响因子：
3
通讯作者：
Choi, Yong
中科院分区：
文献类型：
--
作者：
Cheong, Hae Il;Cho, Hee Yeon;Choi, Yong
偶尔有关于儿童双重肾小球病的病例报告，涉及两种不同肾小球病的共存或第二种肾小球病叠加在第一种肾小球病上。对294例接受肾活检的儿童进行了回顾性临床病理分析，结果9例（3.1%）被证实患有双肾小球病。重叠肾小球病诊断的第二次肾活检的情况下，和共存的两个肾小球病证实了一个单一的活检7。原发性肾小球病是那些具有慢性病程的疾病，如Alport综合征、伊加肾病、复发性微小病变肾病综合征、Frasier综合征和薄基底膜肾病。儿童肾小球疾病以重叠型多见，如感染后肾小球肾炎、伊加肾病、过敏性肾炎等。因此，认为双重肾小球病的模式是由于两种不同肾小球病的偶然发生而没有共同的发病机制。在大多数情况下，急性肾炎症状的叠加肾小球病几乎完全解决了随访期间。双肾小球病在儿童中并不罕见，在大多数情况下可能只是偶然发生。如果肾小球病的临床过程发生了病理性改变，则应怀疑其为叠加性肾小球病。然而，叠加肾小球疾病对肾功能恶化的长期影响仍不清楚。
Occasional case reports have been issued on children with double glomerulopathy, involving either the coexistence of two different glomerulopathies or superimposition of a second glomerulopathy onto a first. A retrospective clinicopathological review of 294 children who had received renal biopsies resulted in 9 (3.1%) being confirmed to have double glomerulopathy. Superimposed glomerulopathy was diagnosed by a second renal biopsy in two cases, and coexistence of two glomerulopathies was confirmed by single biopsy in seven. Original glomerulopathies were those with a chronic course, such as Alport syndrome, IgA nephropathy, relapsing minimal-change nephrotic syndrome, Frasier syndrome, and thin basement membrane nephropathy. The superimposing glomerulopathies were common types in children, such as postinfectious glomerulonephritis, IgA nephropathy, and Henoch-Schonlein nephritis. Thus, the pattern of double glomerulopathy was considered to be due to the chance occurrence of two different glomerulopathies without a common pathogenesis. Acute nephritic symptoms of superimposed glomerulopathies resolved almost completely during follow-up in most cases. Double glomerulopathies are not rare in children and may occur by chance alone in most cases. The possibility of superimposed glomerulopathy should be suspected if the clinical course of a glomerulopathy changes atypically. However, the long-term influence of a superimposed glomerulopathy on renal functional deterioration remains unclear.