溃疡性结肠炎合并IgA肾病1例

A Case Report of Ulcerative Colitis Complicated with IgA Nephropathy

摘要: 目的：通过1例病例报道分析一位溃疡性结肠炎合并IgA肾病的患者诊疗经过，从临床表现、内镜特点及肾组织学病理进行总结，增加对溃疡性结肠炎合并IgA肾病的认识。方法：报道溃疡性结肠炎合并IgA肾病1例。结果：患者在溃疡性结肠炎疾病治疗过程中，出现蛋白尿、血尿，行肾穿刺活检确诊IgA肾病，予以调整治疗溃疡性结肠炎药物，并加用肾保护药物，患者症状缓解，目前正在密切随访中。结论：炎症性肠病(IBD)与IgA肾病(IgAN)作为具有潜在关联的慢性炎症性疾病，其共同发病机制尚待阐明。本病例提示IBD患者应常规监测肾功能及尿常规等，两病在黏膜免疫、遗传易感性等层面的机制关联为靶向治疗提供新思路。

Abstract: Objective: To analyze the diagnosis and treatment process of a patient with ulcerative colitis complicated with IgA nephropathy through a case report, and summarize the clinical manifestations, endoscopic features and renal histopathology to enhance the understanding of ulcerative colitis complicated with IgA nephropathy. Methods: A case of ulcerative colitis complicated with IgA nephropathy was reported. Results: During the treatment of ulcerative colitis, the patient developed proteinuria and hematuria. Renal biopsy confirmed IgA nephropathy. The treatment for ulcerative colitis was adjusted and renal protective drugs were added. The patient’s symptoms were relieved and they are currently under close follow-up. Conclusion: Inflammatory bowel disease (IBD) and IgA nephropathy (IgAN) are chronic inflammatory diseases with potential associations. The common pathogenesis remains to be clarified. This case suggests that IBD patients should routinely monitor renal function and urine routine. The mechanism association between the two diseases at the levels of mucosal immunity and genetic susceptibility provides new ideas for targeted therapy.