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中华肾病研究电子杂志 ›› 2020, Vol. 09 ›› Issue (03) : 138 -141. doi: 10.3877/cma.j.issn.2095-3216.2020.03.011

所属专题: 经典病例 经典病例 文献

病例报告

同基因造血干细胞移植受者发生肾病综合征1例
吴晶晶1, 白明传1, 缪扣荣2, 朱敬凤1, 孙彬1, 赵秀芬1, 钱军1, 邢昌赢1, 毛慧娟1,()   
  1. 1. 210029 南京,江苏省人民医院(南京医科大学第一附属医院)肾内科
    2. 210029 南京,江苏省人民医院(南京医科大学第一附属医院)血液科
  • 收稿日期:2020-01-30 出版日期:2020-06-28
  • 通信作者: 毛慧娟

A case of nephrotic syndrome in a recipient of isogenic hematopoietic stem cell transplantation

Jingjing Wu1, Mingchuan Bai1, Kourong Miao2   

  • Received:2020-01-30 Published:2020-06-28
引用本文:

吴晶晶, 白明传, 缪扣荣, 朱敬凤, 孙彬, 赵秀芬, 钱军, 邢昌赢, 毛慧娟. 同基因造血干细胞移植受者发生肾病综合征1例[J]. 中华肾病研究电子杂志, 2020, 09(03): 138-141.

Jingjing Wu, Mingchuan Bai, Kourong Miao. A case of nephrotic syndrome in a recipient of isogenic hematopoietic stem cell transplantation[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2020, 09(03): 138-141.

图1 患者同胞同基因造血干细胞移植具体用药方案
图2 肾活检:光镜(A和B):系膜细胞节段性轻度增生,系膜基质局灶节段性轻度增多,毛细血管开放,可见少数微血栓,少数小球球囊粘连。免疫荧光:IgG:基底膜弥漫性颗粒样(++++)(C);IgA:基底膜弥漫性颗粒样(+)(D)。电镜(E和F):包曼氏囊壁周围见大量纤维母细胞,毛细血管袢极少;仅见一个足细胞,包浆空泡变性。肾小球内可见节段上皮下电子致密物沉积
图3 治疗过程中类固醇激素、环磷酰胺、环孢素具体调整方案
图4 治疗过程中24 h尿蛋白和血清白蛋白的变化趋势。24 h尿蛋白经过类固醇激素、环磷酰胺、环孢素治疗后可显著缓解并长期维持在正常水平内
图5 治疗过程中24 h尿蛋白和血清肌酐的变化趋势
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