Systemic Lupus Erythematosus Complicated by Hemolytic Uremic Syndrome:A Case Report

系統性紅斑狼瘡併發溶血性尿毒症候群—病例報告

林新泰(Shin-Tai Lin) ； 謝適仲(Su-Jong Hsieh) ； 江守山(Shou-Shan Chiang) ； 楊安航(An-Hang Yang)

《Acta Nephrologica》 14卷1期 (2000/01) Pp. 31-34

摘要

溶血性尿毒症候群是一種疾病，其中主要有三個特徵：急性腎衰竭，血小板低下症，以及微小血管病變所導致溶血性貧血。然而，溶血性尿毒症候群很少併發於系統性紅斑狼瘡。本篇報告一位三十歲女性因為急性腎衰竭，於1999年2月住進本院。住院後腎臟切片顯示出腎絲球微血管管腔阻塞，以及許多紅血球裂碎片，隨後的免疫學檢查，也顯示出高效價的抗雙股DNA。
狼瘡併發生溶血性尿毒症候群。在接受過血液透析、血漿置換術以及類固醇治療後，腎功能以及血液病變逐漸復原且無任何後遺症。所以我們建議臨床醫師必須警覺到，系統性紅斑狼瘡可引起溶血性尿毒症候群，而儘早的血漿置換術合併類固醇的治療，對於此病有很大的療效。

關鍵字

系統性紅斑狼瘡 ； 溶血性尿毒症候群 ； 血漿置換術

並列摘要

Hemolytic uremic syndrome is a disease characterized by acute renal failure, thrombocytopenia, and microangiopathic hemolytic anemia. Hemolytic uremic syndrome has been considered to occur rarely in systemic lupus erythematosus. We present a 30-year-old woman who was admitted on account of acute renal failure in Feb 1999. Renal biopsy was preformed and renal pathology, seen on light and electron microscopy, disclosed obliteration of capillary lumens and fragments of red blood cells. Subsequent immunological studies revealed high titers of antibodies against double-stranded DNA. She was diagnosed with systemic lupus erythematosus complicated by hemolytic uremic syndrome. Treatment with supportive hemodialysis, plasma exchange and corticosteroids resulted in complete recovery of renal function and hematological abnormalities. We suggest that systemic lupus erythematosus may cause hemolytic uremic syndrome. Early therapeutic interventions with supportive hemodialysis, plasma exchange and corticosteroids can lead to a good prognosis.

並列關鍵字

systemic lupus erythematosus ； hemolytic uremic syndrome ； plasma exchange