혈장교환술 시행 후 호전된 감염성 심내막염으로 인한 급속 진행성 사구체 신염 1예
Rapidly progressive glomerulonephritis associated with infective endocarditis : a dramatically improved case after plasmapheresis
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초록
저자들은 심실 중격 결손이 있고, 감염성 심내막염이 생긴 28세 여자 환자에서 합병증으로 발생한 급속 진행성 사구체 신염이 항생제 치료, 혈장 교환술 그리고 수술로 임상적 증상이 현저히 좋아진 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
A 28-year-old woman was admitted due to fever, dyspnea, hematuria and acute renal insufficiency. 1 months ago, she had been diagnosed as having ventricular septal defect with mild dyspnea and chronic cough. Infective endocarditis (IE) was diagnosed by clinical findings including vegetation in echocardiography. A blood culture drawn during the hospitalization grew streptococcus sanguis. A renal biopsy showed IE-induced crescentic glomerulonephritis (GN). Antibiotic treatment alone was effective for fever, but not for gross hematuria and renal insufficiency. After the initiation of plasmapheresis, gross hematuria and acute renal insufficiency was dramatically improved. After clinical stability was achieved, closure of the ventricular septal defect was performed. This result suggests that plasmapheresis may be beneficial in the treatment infective endocarditis-induced crescent GN.
참고문헌 (11)
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