PDF(Pubmed)
Abstract：
We report a 53-year-old man who presented with acute renal failure. His medical history revealed a spondyloarthropathy, for which secukinumab was started recently, and a monoclonal gammopathy of unknown significance. Kidney function deteriorated despite the withdrawal of secukinumab and dialysis was started. In the serum, type 1 cryoglobulins were present and a kidney biopsy showed ischaemic glomeruli, with thrombosis of the larger interlobular arteries. Other causes of thrombotic microangiopathy were excluded. Bone marrow immunophenotyping showed 1% monoclonal plasma cells. A diagnosis of monoclonal gammopathy of renal significance was made. Haematological treatment resulted in haematological and renal response.
摘要：
我们报告了一名53岁的男性，他患有急性肾功能衰竭。他的病史显示患有脊椎关节病,苏金单抗最近开始使用，和未知意义的单克隆丙种球蛋白病。尽管停用苏金单抗并开始透析，肾功能仍恶化。在血清中，1型冷球蛋白存在，肾活检显示缺血性肾小球，伴有较大的小叶间动脉血栓形成。排除血栓性微血管病的其他原因。骨髓免疫分型显示1％的单克隆浆细胞。诊断出具有肾脏意义的单克隆丙种球蛋白病。血液治疗导致血液和肾脏反应。
