만성신질환의 경과 중 급성 악화를 보인 허탈성 사구체병증의 진단 1예
A Case of Idiopathic Collapsing Glomerulopathy Showing Aggravation on a Chronic Progressive Course
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Collapsing glomerulopathy (CG) has become an important cause of end-stage renal disease (ESRD). First delineated from other proteinuric glomerular lesions in the 1980s, CG is now recognized as a common, distinct pattern of proliferative parenchymal injury that portends a rapid loss of renal function and poor responses to empirical therapy. The first cases in the literature trace back to human-immunodeficiency-virus (HIV)-negative patients who underwent biopsy in 1979. A 45-year-old male patient complained of hematuria and proteinuria eight years ago. He showed an abrupt serum creatinine increase from 1.75 to 2.65mg/dL in the last preceding months. Afterwards, his serum creatinine progressively increased up to 6.82mg/dL. Moreover, his 24 h urine protein level was determined to have reached 6,171 mg/day, as opposed to 670 mg/day a year earlier. Consequently, renal biopsy was performed, and its result showed collapsing glomerulopathy, compatible with the diagnosis. He has undergone continuous ambulatory peritoneal dialysis as renal replacement therapy. Thus, it is reported herein that a patient clinically diagnosed with chronic kidney disease eight years ago showed a sudden renal-function decrease and was clinicopathologically diagnosed with collapsing glomerulopathy based on the results of his renal biopsy.
Abstract
Collapsing glomerulopathy (CG) has become an important cause of end-stage renal disease (ESRD). First delineated from other proteinuric glomerular lesions in the 1980s, CG is now recognized as a common, distinct pattern of proliferative parenchymal injury that portends a rapid loss of renal function and poor responses to empirical therapy. The first cases in the literature trace back to human-immunodeficiency-virus (HIV)-negative patients who underwent biopsy in 1979. A 45-year-old male patient complained of hematuria and proteinuria eight years ago. He showed an abrupt serum creatinine increase from 1.75 to 2.65mg/dL in the last preceding months. Afterwards, his serum creatinine progressively increased up to 6.82mg/dL. Moreover, his 24 h urine protein level was determined to have reached 6,171 mg/day, as opposed to 670 mg/day a year earlier. Consequently, renal biopsy was performed, and its result showed collapsing glomerulopathy, compatible with the diagnosis. He has undergone continuous ambulatory peritoneal dialysis as renal replacement therapy. Thus, it is reported herein that a patient clinically diagnosed with chronic kidney disease eight years ago showed a sudden renal-function decrease and was clinicopathologically diagnosed with collapsing glomerulopathy based on the results of his renal biopsy.
참고문헌 (18)
- Rydel JJ, "Focal segmental glomerular sclerosis in adults: presentation, course, and response to treatment", Am J Kidney Dis, 25, pp.534~542 (1995)
- Deltwiler RK, "Collapsing glomerulopathy:a clinically and pathologically distinct variant of focal segmental glomerulosclerosis", Kidney Int, 45, pp.1416~1424 (1994)
- Weiss MA, "Nephrotic syndrome, progressive irreversible renal failure, and glomerular “collapse”: a new clinicopathologic entity?", Am J Kidney Dis, 7, pp.20~28 (1986)
- Valeri A, "Idiopathic collapsing focal segmental glomerulosclerosis: A clinicopathologic study", Kidney Int, 50, pp.1734~1736 (1996)
- Chun MJ, "Focal segmental glomerulosclerosis in nephrotic adults: presentation, prognosis, and response to therapy of the histologic variants", J Am Soc Nephrol, 15, pp.2169~2177 (2004)
- Markowitz GS, "Collapsing focal segmental glomerulosclerosis following treatment with high-dose pamidronate", J Am Soc Nephrol, 12, pp.1164~1172 (2001)
- Weisinger JR, "The nephrotic syndrome: a complication of massive obesity", Ann Intern Med, 81, pp.440~447 (1974)
- Albaqumi M, "Collapsing glomerulopathy", J Am Soc Nephrol, 17, pp.2854~2863 (2006)
- Albaqumi M, "Current views on collapsing glomerulopathy", J Am Soc Nephrol, 19, pp.1276~1281 (2008)
- Grcevska L, "Collapsing glomerulopathy:Clinical characteristics and follow-up", Am J Kidney Dis, 33, pp.652~657 (1999)
- Haas M., "Collapsing glomerulopathy: many means to a similar end", Kidney International, 73, pp.669~671 (2008)
- Bolton WK, "Pathogenesis of focal glomerulosclerosis", Nephrone, 88, pp.6~13 (2001)
- Thomas DB, "Clinical and pathologic characteristics of focal segmental glomerulosclerosis pathologic variants", Kidney Int, 69, pp.920~926 (2006)
- D’agati VD, "Pathologic classification of focal segmental glomerulosclerosis: a working proposal", Am J Kidney Dis, 43, pp.368~382 (2004)
- Meyrier AY, "Collapsing glomerulopathy: expanding interest in a shrinking tuft", Am J Kidney Dis, 33, pp.801~803 (1999)
- Barisoni L, "A proposed taxonomy for the podocytopathies: a assessment of the primary nephrotic disease", Clin J Am Soc Nephrol, 2, pp.529~542 (2007)
- Howie JA, "Problems with ‘focal segmental glomerulosclerosis’", Pediatr Nephrol, 26, pp.1197~1205 (2011)
- 김용진, "초점성 분절성 사구체 경화증의 병리와 분류", Childhood Kidney Diseases, 16(1), pp.21~31 (2012), 대한소아신장학회[DOI]