Renal granuloma and immunoglobulin M-complex glomerulonephritis: a case of common variable immunodeficiency?
Renal granuloma and immunoglobulin M-complex glomerulonephritis: a case of common variable immunodeficiency?
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DOI：
10.1007/s00467-008-0958-z
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发表时间：
2009-03-01
影响因子：
3
通讯作者：
Haddad, Elie
中科院分区：
文献类型：
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作者：
Benoit, Genevieve;Lapeyraque, Anne-Laure;Haddad, Elie
常见变异型免疫缺陷（CVID）的特征是血清免疫球蛋白水平降低和反复细菌感染。肉芽肿性浸润偶尔见于淋巴或实体器官的受影响的病人，但肾脏受累是罕见的。我们提出了一个可能的CVID与间质性非干酪化肉芽肿和免疫球蛋白（IgM）复合物肾小球肾炎膜增生性模式和有利的反应，皮质类固醇，静脉注射免疫球蛋白（IVIG）和利妥昔单抗。CVID必须包括在肾肉芽肿的鉴别诊断中，并应与结节病鉴别，以确保适当的治疗。
Common variable immunodeficiency (CVID) is characterized by reduced serum immunoglobulin levels and recurrent bacterial infections. Granulomatous infiltrations are occasionally found in the lymphoid or solid organs of affected patients, but renal involvement is rare. We present a case of possible CVID with interstitial noncaseating granuloma and immunoglobulin (IgM)-complex glomerulonephritis with a membranoproliferative pattern and with a favorable response to corticosteroids, intravenously administered immunoglobulins (IVIGs) and rituximab. CVID must be included in the differential diagnosis of renal granuloma and should be differentiated from sarcoidosis to ensure appropriate therapy.