Remission of membranoproliferative glomerulonephritis associated with a noncirrhotic portosystemic shunt after percutaneous transhepatic portal vein embolization

被引：4

作者：

Okamoto, Nobuhiko ^{[1
]}

Fukazawa, Sawako ^{[1
]}

Shimamoto, Masafumi ^{[1
]}

Yamamoto, Rie ^{[1
]}

Fukazawa, Yuichiro ^{[2
]}

机构：

[1] Sapporo Hosp, Nippon Telegraph & Tel East Corp, Dept Nephrol, Sapporo, Hokkaido 0620931, Japan

[2] KKR Sapporo Med Ctr, Dept Pathol, Sapporo, Hokkaido 0620931, Japan

来源：

CLINICAL KIDNEY JOURNAL | 2009年 / 2卷 / 04期

关键词：

cirrhosis-associated IgA nephropathy; membranoproliferative glomerulonephritis; noncirrhotic portosystemic shunt; percutaneous transhepatic portal vein embolization;

D O I：

10.1093/ndtplus/sfp019

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

We present a case of a 75-year-old man with nephrotic syndrome and renal insufficiency caused by immune complex-mediated secondary membranoproliferative glomerulonephritis. He developed hepatic encephalopathy. A congenital portosystemic shunt was identified, indicating a diagnosis of membranoproliferative glomerulonephritis with noncirrhotic portosystemic shunt. Proteinuria resolved after shunt ratio reduction by percutaneous transhepatic portal vein embolization. Renal function and histopathological findings improved without immunosuppressive therapy. This case emphasizes the role of a high shunt ratio and reduced hepatic clearance of circulating immune complexes in such nephropathy. Membranoproliferative glomerulonephritis with a shunt may cause refractory nephrotic syndrome, but embolization is effective.

引用

页码：228 / 232

页数：5

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