Childhood fibrillary glomerulonephritis:one case report and literature review

目的 分析儿童纤维性肾小球肾炎的临床特点和诊治.方法 回顾分析1例2016年4月收治的纤维性肾小球肾炎患儿的临床资料.结果 患儿,男,12岁,6岁时发现有大量蛋白尿(以白蛋白为主)、低白蛋白血症、高胆固醇血症及持续镜下血尿,符合肾病综合征.行肾穿刺活检病理示重度系膜增生性肾小球病变伴硬化.予甲基泼尼松龙冲击、泼龙松治疗无效,联合骁悉、中药等治疗仍效果不佳.本次入院后第2次肾活检,病理光镜示中度系膜增生性肾小球肾炎并膜增生样改变,电镜示纤维样肾小球肾炎.结论 确诊国内首例儿童FGN.Objective To explore the clinical features, diagnosis, and treatment of childhood fibrillary glomerulonephritis (FGN). Methods The clinical data of a child with FGN in April 2016 were analyzed retrospectively. Results A 12-year-old boy, who presented significant proteinuria (mainly albumin), hypoalbuminemia, hypercholesterolemia, and persistent microscopic hematuria in May 2010, met the criteria of nephrotic syndrome. Renal biopsy in May 2010 showed mesangial proliferative glomerulonephritis combined with glomerulosclerosis. It was not effective by treatment with intravenous infusion of methylprednisolone and prednisolone, and there were no responses by the combination with mycophenolate mofetil and traditional Chinese medicine. After admission, the second renal biopsy was performed. Under the light microscope, the moderate mesangial proliferative glomerulonephritis combined with membranoproliferative changes was observed. Under the electron microscope, the FGN was confirmed. Conclusion The first case of childhood FNG was diagnosed in China.9687-6903