UNASSIGNED: Two cases of renal impairment after taking red yeast supplement internally are presented. Both cases showed renal dysfunction with low uric acid, potassium, and phosphorus levels, characteristic features of Fanconi syndrome. The renal biopsy findings of both cases showed severe injury to the proximal tubules with mild inflammatory cell infiltration. The proximal tubules exhibited diffuse loss of the brush border, flattening, and tubular lumen dilation. Immunofluorescence showed no deposition of immunoglobulin and complement in the glomeruli and tubules. Electron microscopic findings indicated proximal tubular damage without crystal deposition. Moreover, immunohistochemistry using the proximal tubular marker CD10 and a marker for distal tubules including the loop of Henle, E-cadherin, collectively demonstrated that the focus of renal injury in both cases was mainly the proximal tubules.
UNASSIGNED: The red yeast rice supplement itself, its metabolized product, or other unknown contaminant components might directly induce proximal tubulopathy rather than an allergic reaction-related tubulointerstitial nephritis.
■介绍了2例内部服用红曲补充剂后出现肾功能损害的病例。两例均表现为肾功能不全低尿酸,钾,和磷水平,范可尼综合征的特征性特征。两种情况的肾活检结果均显示近端小管严重损伤,并伴有轻度炎症细胞浸润。近端小管表现出刷状边界的弥漫性损失,展平,和管状管腔扩张。免疫荧光显示肾小球和肾小管中没有免疫球蛋白和补体沉积。电子显微镜发现表明近端管状损伤,没有晶体沉积。此外,使用近端肾小管标记CD10和远端肾小管标记包括Henle环的免疫组织化学,E-cadherin,共同证明,在这两种情况下,肾损伤的重点主要是近端小管。
■红曲米补充剂本身,它的代谢产物,或其他未知污染物成分可能直接诱发近端肾小管病变,而不是过敏反应相关的肾小管间质性肾炎。