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使用二甲氧苯青霉素(Methicillin,简称新青Ⅰ号)时可并发间质性肾炎致肾功能衰竭。临床上有发热、皮疹、嗜酸性白细胞增多、蛋白尿及用药数日后出现肾脏间质炎性浸润,均提示为免疫反应所致。Baldwin曾报告一个这种病例,在肾小球基底膜(GBM)和肾小管基底膜(TBM)上都发现具有半抗原作用的二甲氧苯青霉素基(Dimethoxyphenyl pencilloyl,简称DPO)和免疫球蛋白(Ig)作线状沉着。本文报告一例右侧大腿枪伤感染,于应用新青Ⅰ号后发生血尿和肾衰,肾活检显示严重的问质性肾炎。用直接免疫萤光试验证明TBM上有IgG和补体C_3沉着,并有DPO沉着,而GBM上则没有。病人的血清经间接免疫萤光试验证明含有抗正常人TBM
The use of methicillin (Methicillin, referred to as Xinqing I) may be associated with interstitial nephritis caused by renal failure. Clinically, fever, rash, eosinophilia, proteinuria and renal interstitial inflammatory infiltration several days later, all prompted by the immune response. One such case was reported by Baldwin. Dimethoxyphenyl pencilloyl (DPO) and immunoglobulin with hapten effects were found on the glomerular basement membrane (GBM) and the tubular basement membrane (TBM) (Ig) for linear deposition. This article reports a case of right thigh gunshot wound infection, hematuria and renal failure after application of new youth Ⅰ, renal biopsy showed severe astritis. Direct immunofluorescence assay demonstrated IgG and complement C_3 sedation on TBM with DPO sedation but not on GBM. The patient’s serum proved to contain anti-normal human TBM by indirect immunofluorescence assay