PDF(Pubmed)
Abstract：
A Japanese female in her twenties developed general edema with heavy proteinuria, and was referred to our hospital. She exhibited the common clinical manifestation of idiopathic nephrotic syndrome with massive proteinuria (20.37 g/day), hypoalbuminemia (1.8 g/dL), and hypercholesterolemia (300 mg/dL). Routine admission tests were positive results for both the rapid plasma reagin latex agglutination test for syphilis (RPR) and the Treponema pallidum particle agglutination assay (TPHA). As such, we made her a diagnosis of nephrotic syndrome due to secondary syphilis. Renal biopsy revealed \"full-house\" nephropathy. Following the commencement of penicillin treatment, she developed skin rash, indicating the Jarisch-Herxheimer reaction (JHR). Her nephrotic syndrome responded rapidly and she achieved complete remission with antibiotic therapy alone after 4 weeks. In light of the increasing incidence of syphilis in Japan, clinicians should consider syphilis as a reversible cause of nephrotic syndrome.
摘要：
一名二十多岁的日本女性出现全身水肿伴重度蛋白尿，被转诊到我们医院.她表现为特发性肾病综合征的常见临床表现，伴有大量蛋白尿（20.37g/天），低蛋白血症（1.8g/dL），和高胆固醇血症（300mg/dL）。梅毒快速血浆反应蛋白乳胶凝集试验（RPR）和梅毒螺旋体颗粒凝集试验（TPHA）的常规入院试验均为阳性结果。因此，我们把她诊断为肾病综合征是因为二期梅毒。肾活检显示“全屋”肾病。开始青霉素治疗后，她出现了皮疹,表明Jarisch-Herxheimer反应（JHR）。她的肾病综合征反应迅速，4周后仅通过抗生素治疗即可完全缓解。鉴于日本梅毒发病率的增加，临床医生应将梅毒视为肾病综合征的可逆性原因.
