临床儿科杂志 ›› 2017, Vol. 35 ›› Issue (9): 687-.doi: 10.3969/j.issn.1000-3606.2017.09.013

• 综合报道 • 上一篇    下一篇

儿童纤维性肾小球肾炎1 例报告并文献复习

张宏文1, 崔洁媛1,2* , 苏白鸽1, 姚勇1   

  1. 1 . 北京大学第一医院儿科(北京 100034);2 . 河北省儿童医院肾脏免疫科(河北石家庄 050031)
  • 收稿日期:2017-09-15 出版日期:2017-09-15 发布日期:2017-09-15
  • 通讯作者: 姚勇 E-mail:yaoyong3238@126 .com

Childhood fibrillary glomerulonephritis: one case report and literature review

 ZHANG Hongwen1 , CUI Jieyuan 1,2 , SU Baige1, YAO Yong1   

  1. 1.Department of Pediatric, Peking University First Hospital, Beijing 100034, China; 2.Department of Nephrology and Immunology, Hebei Children’s Hospital, Shijiazhuang 050031, Hebei, China
  • Received:2017-09-15 Online:2017-09-15 Published:2017-09-15

摘要: 目的 分析儿童纤维性肾小球肾炎的临床特点和诊治。方法 回顾分析1例2016年4月收治的纤维性肾小 球肾炎患儿的临床资料。结果 患儿,男,12岁, 6岁时发现有大量蛋白尿(以白蛋白为主)、低白蛋白血症、高胆固醇血症 及持续镜下血尿,符合肾病综合征。行肾穿刺活检病理示重度系膜增生性肾小球病变伴硬化。予甲基泼尼松龙冲击、泼龙 松治疗无效,联合骁悉、中药等治疗仍效果不佳。本次入院后第2次肾活检,病理光镜示中度系膜增生性肾小球肾炎并膜 增生样改变,电镜示纤维样肾小球肾炎。结论 确诊国内首例儿童FGN。

Abstract:  Objective To explore the clinical features, diagnosis, and treatment of childhood fibrillary glomerulonephritis (FGN). Methods The clinical data of a child with FGN in April 2016 were analyzed retrospectively. Results A 12-yearold boy, who presented significant proteinuria (mainly albumin), hypoalbuminemia, hypercholesterolemia, and persistent microscopic hematuria in May 2010, met the criteria of nephrotic syndrome. Renal biopsy in May 2010 showed mesangial proliferative glomerulonephritis combined with glomerulosclerosis. It was not effective by treatment with intravenous infusion of methylprednisolone and prednisolone, and there were no responses by the combination with mycophenolate mofetil and traditional Chinese medicine. After admission, the second renal biopsy was performed. Under the light microscope, the moderate mesangial proliferative glomerulonephritis combined with membranoproliferative changes was observed. Under the electron microscope, the FGN was confirmed. Conclusion The first case of childhood FNG was diagnosed in China.