Glomerular calcification in hypercalcemic nephropathy.
Glomerular calcification in hypercalcemic nephropathy.
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高钙血症肾病的肾小球钙化。
DOI：
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发表时间：
2003
影响因子：
4.6
通讯作者：
M. Hughson
中科院分区：
文献类型：
--
作者：
J. Henegar;J. Coleman;J. Cespedes;M. Hughson
高钙血症肾病被归类为肾小管间质性肾病。仅在少数患者中观察到由高钙血症引起的肾小球病理学改变，因此认为这是一种不寻常的发现。在本研究中，在2例血清钙水平极度升高和高钙血症肾病患者中研究了肾小球内的钙沉积。研究材料包括一名患有T细胞淋巴瘤/白血病且血清钙水平为20.2 mg/dL（5.0 mmol/L）的31岁女性（患者1）的肾活检标本和一名正在接受原发性甲状旁腺功能亢进评价且钙水平为18.4 mg/dL（4.6 mmol/L）的19岁女性（患者2）的尸检肾脏标本。患者1的肾活检标本显示肾小球毛细血管基底膜中存在钙沉积，与节段性硬化性病变（21%的肾小球）相关。9%的皮质小管含有钙化。在患者2中，95%的肾小球在系膜区发现钙，7%的肾小球填充Bowman腔，或与毛细血管基底膜和节段性硬化性病变（12%的肾小球）相关。15%的皮质小管、4%的外髓小管和40%的内髓小管钙化。在这两种情况下，没有免疫荧光或电子显微镜证据的原发性肾小球疾病。因此，肾小球钙化可能超过皮质和外髓小管，并可能在高钙肾病肾功能丧失中起重要作用。肾小球钙质沉着症也可能被认为是极高血清钙水平患者节段性肾小球硬化和肾病范围蛋白尿的另一个原因。
Hypercalcemic nephropathy has been classified as a tubulointerstitial renal disease. The presence of glomerular pathologic findings attributable to hypercalcemia has been observed in only a few patients and therefore has been considered an unusual finding. In the current study, calcium deposition within glomeruli was investigated in 2 patients with extreme elevations in serum calcium levels and hypercalcemic nephropathy. The study material consisted of a renal biopsy specimen from a 31-year-old woman (patient 1) who had T-cell lymphoma/leukemia and a serum calcium level of 20.2 mg/dL (5.0 mmol/L) and autopsy kidney specimens from a 19-year-old woman (patient 2) who was being evaluated for primary hyperparathyroidism and a calcium level of 18.4 mg/dL (4.6 mmol/L). The renal biopsy specimen for patient 1 exhibited calcium deposits present in the glomerular capillary basement membranes, where they were associated with segmental sclerosing lesions (21% of glomeruli). Nine percent of the cortical tubules contained calcifications. In patient 2, calcium was found in the mesangial areas in 95% of glomeruli, filling the Bowman space in 7% of glomeruli, or associated with capillary basement membranes and segmental sclerosing lesions (12% of glomeruli). Fifteen percent of cortical tubules, 4% of outer medullary tubules, and 40% of inner medullary tubules were calcified. In neither case was there immunofluorescence or electron microscopic evidence of primary glomerular disease. Thus, glomerular calcification may exceed that occurring in the cortical and outer medullary tubules and may play a significant role in the loss of renal function in hypercalcemic nephropathy. Glomerular calcinosis may also be recognized as an additional cause of segmental glomerulosclerosis and nephrotic range proteinuria in patients with extremely high levels of serum calcium.
高钙血症肾病：以髓质内条纹损伤为主的慢性疾病。
影响因子：
19.6
作者：
Rosen,S;Greenfeld,Z;Bernheim,J;Rathaus,M;Podjarny,E;Brezis,M
通讯作者：
Brezis,M