A case of ANCA-associated small-vessel vasculitis complicated with atypical membranous nephropathy

doi:10.3877/cma.j.issn.2095-3216.2018.05.011

Chinese Journal of Kidney Disease Investigation(Electronic Edition) ›› 2018, Vol. 07 ›› Issue (05): 238-240. doi: 10.3877/cma.j.issn.2095-3216.2018.05.011

Special Issue: ；；；

• Case Report • Previous Articles

A case of ANCA-associated small-vessel vasculitis complicated with atypical membranous nephropathy

Lingjie Wu¹, Lijun Liu², Lei Zhang¹()

Received:2018-04-08 Online:2018-10-28 Published:2018-10-28
Contact: Lei Zhang

Abstract

Lingjie Wu, Lijun Liu, Lei Zhang. A case of ANCA-associated small-vessel vasculitis complicated with atypical membranous nephropathy[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2018, 07(05): 238-240.

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References 6

[1]	Sherkat R, Mostafavizadeh K, Zeydabadi L, et al. Antineutrophil cytoplasmic antibodies in patients with pulmonary tuberculosis [J]. Iran J Immunol, 2011, 8(1): 52-57.
[2]	Ronco P, Debiec H. Membranous nephropathy: a fairy tale for immunopathologists, nephrologists and patients [J]. Mol Immunol, 2015, 68(1): 57-62.
[3]	Markowitz GS. Membranous glomerulopathy: emphasis on secondary forms and disease variants [J]. Adv Anat Pathol, 2001, 8(3): 119-125.
[4]	Zou R, LiuG, Cui Z, et al. Clinical and immunologic characteristics of patients with ANCA-associated glomerulonephritis combined with membranous nephropathy: a retrospective cohort study in a single Chinese center [J]. Medicine (Baltimore), 2015, 94(37): 1-10.
[5]	Carlsson M, Shukla S, Petersson AC, et al. Pseudomonas aeruginosa in cystic fibrosis: pyocyanin negative strains are associated with BPI-ANCA and progressive lung disease [J]. J Cyst Fibros, 2011, 10(4): 265-271.
[6]	Kidney Disease Improving Global Outcomes (KDIGO) Glomerulonephritis Work Group. KDIGO clinical practice guideline for glomerulonephritis [J]. Kidney Int Suppl, 2012, 2(2): 139-274.

项目	2017-11-02	2017-11-30	2017-12-30	2018-03-02	2018-04-26
尿蛋白定性	2＋	1＋	3＋	1＋	1＋
尿潜血	±	±	±	-	±
血白细胞(×10⁹/L)	5.46	5.09	4.41	10.63	6.41
血红蛋白(g/L)	127	106	103	114	118
血小板(×10⁹/L)	?	274	171	231	188
C反应蛋白(mg/L)	4.8	?	4.1	7.2	2.3
血白蛋白(g/L)	30	?	20	34	37
肌酐(μmol/L)	55.6	?	52.3	67.6	71.2
C3(0.83～1.93)g/L	1.0	?	0.82	?	0.97
C4(0.15～0.57)g/L	0.18	?	0.18	?	0.21
24 h尿蛋白(mg)	3 335	5 252	?	516	137
抗核抗体(IgG型)	1∶320	1∶3 200	?	1∶1 000	1∶1 000
血沉(mm/h)	－	80	100	21	?
ANCA(IIF)	－	阳性P型	阳性P型	?	荧光阳性
抗PR3抗体(RU/L)	?	－	－	?	－
抗MPO抗体(RU/L)	?	0.059	0.085	?	－
PLA2R－Ab(RU/L)	?	－	?	?

项目	2017-11-02	2017-11-30	2017-12-30	2018-03-02	2018-04-26
尿蛋白定性	2＋	1＋	3＋	1＋	1＋
尿潜血	±	±	±	-	±
血白细胞(×10⁹/L)	5.46	5.09	4.41	10.63	6.41
血红蛋白(g/L)	127	106	103	114	118
血小板(×10⁹/L)	?	274	171	231	188
C反应蛋白(mg/L)	4.8	?	4.1	7.2	2.3
血白蛋白(g/L)	30	?	20	34	37
肌酐(μmol/L)	55.6	?	52.3	67.6	71.2
C3(0.83～1.93)g/L	1.0	?	0.82	?	0.97
C4(0.15～0.57)g/L	0.18	?	0.18	?	0.21
24 h尿蛋白(mg)	3 335	5 252	?	516	137
抗核抗体(IgG型)	1∶320	1∶3 200	?	1∶1 000	1∶1 000
血沉(mm/h)	－	80	100	21	?
ANCA(IIF)	－	阳性P型	阳性P型	?	荧光阳性
抗PR3抗体(RU/L)	?	－	－	?	－
抗MPO抗体(RU/L)	?	0.059	0.085	?	－
PLA2R－Ab(RU/L)	?	－	?	?

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