- 期刊
HCV Infection Complicated with Nephrotic Syndrome, Immune Complex Crescentic Glomerulonephritis and Acute Renal Failure: A Case Report
感染HCV男性併發腎病症候群、免疫複合體、半月狀腎絲球腎炎以及急性腎衰竭之一－病例報告
摘要
已有廣泛的證據指出HCV相關的自體免疫性在一群自體免疫疾病中扮演的角色，但常被忽略。在此我們提出一位HCV感染之男性，表現出腎病症候群、可摸性紫瘢、冷凝球蛋白血症、低補體血症、併發免疫性複合體腎絲球腎炎以及腎衰竭。起初認為只是HCV相關性冷凝球蛋白血症腎絲球腎炎；然而，腎臟切片顯示全盤性激奇(full house)腎絲球腎炎，不禁令人思索：此病的元兇是誰？此外針對臨床醫師無可避免面臨的“HCV相關性自體免疫疾病出現似狼瘡性腎炎之轉換”，提出治療之經驗。
並列摘要
There is ample evidence suggesting that hepatitis C virus (HCV)-associated autoimmunity plays a role in a broad spectrum of autoimmune diseases, which are usually overlooked. We report on a case of nephrotic syndrome, palpable purpura, cryoglobulinemia, hypocomplementemia, and acute renal failure complicated by immune complex glomerulonephritis (GN). The patient is a 64-year-old man with HCV infection, who was initially considered to present only an HCV-associated cryoglobulinemic GN. However, renal biopsy revealed a ”full house” immune complex crescentic GN, which led to our subsequent investigation. The attending clinicians faced what is a common dilemma, where an HCV-associated autoimmune disease inevitably switches to a lupus-like GN. Hence, we also discuss treatment.
延伸閱讀
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