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An uncommon glomerular disease in an HIV patient: value of renal biopsy and review of the literature.

机译:HIV患者中一种罕见的肾小球疾病:肾活检的价值和文献复习。

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摘要

Renal disease is not uncommon in those infected with HIV. The most common manifestation of HIV in the kidney is HIV-associated nephropathy (HIVAN). Other HIV- and non-HIV-related causes have been described in the literature. Immunotactoid glomerulonephritis (ITG) is a rare disorder found in 0.06% of renal biopsies characterized by organized tubular immune complex deposits, observed more often in Caucasians. ITG tends to occur in an older age group and in some patients has been associated with a hemopoietic malignancy. In this report, we describe a case of ITG occurring in an HIV-positive, hepatitis C (HCV)- and hepatitis B (HBV)-negative female, who presented with microscopic hematuria and proteinuria. A percutaneous kidney biopsy showed diffuse membranous glomerulopathy, with mild mesangial proliferation and segmental sclerosing lesions containing mainly IgG, Kappa- and C3-positive deposits. Electron microscopy revealed diffuse subepithelial tubular deposits diagnostic of ITG. Out of 5 reported HIV-positive cases and ITG in the literature, 3 were HCV+, 2 were Caucasian and 3 were African-American (AA) without detectable hematologic malignancy. We report another case of ITG in an HCV- and HBV-negative, AA female.
机译:感染艾滋病毒的人肾脏疾病并不罕见。 HIV在肾脏中最常见的表现是与HIV相关的肾病(HIVAN)。文献中还描述了其他与HIV和非HIV相关的原因。免疫非类固醇性肾小球肾炎(ITG)是在0.06%的肾脏活检组织中发现的一种罕见疾病,其特征是有组织的肾小管免疫复合物沉积,在高加索人中更常见。 ITG倾向于发生在较高年龄组,并且在某些患者中与造血系统恶性肿瘤相关。在本报告中,我们描述了一例ITG病例,该病例发生在HIV阳性,丙型肝炎(HCV)和乙型肝炎(HBV)阴性的女性中,这些女性表现为微观性血尿和蛋白尿。经皮肾活检显示弥漫性膜性肾小球病,伴有轻度的肾小球系膜增生和节段性硬化病变,主要含有IgG,Kappa和C3阳性沉积物。电子显微镜检查显示弥漫性上皮下肾小管沉积物诊断为ITG。在文献中报道的5例HIV阳性病例和ITG中,HCV + 3例,白种人2例,非裔美国人(AA)3例无血液学恶性肿瘤。我们报告了另一例ITG患者,该患者是HCV和HBV阴性,AA女性。

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