RESUMEN
The patient was a young woman with a history of syphilis, gross hematuria onset, chronic course, exacerbation in the second and third trimesters. The clinical manifestations were gross hematuria, nephrotic syndrome, rapidly progressive glomerulonephritis requiring dialysis, decreased complement C3 and C4, and monoclonal IgG-kappa deposition in blood and urine immunofixation electrophoresis. Membranous proliferative glomerulonephritis with crescent formation under renal pathological light microscopy, only single IgG3 deposition in the immunofluorescent IgG subtype, and restrictive expression of light chain kappa, were diagnosed as proliferative glomerulonephritis with monoclonal IgG (IgG3-kappa) deposits (PGNMID). The was the first case with a history of syphilis that worsened during pregnancy. After treatment with bortezomib, cyclophosphamide, and dexamethasone, the patient was finally released from dialysis, renal function recovered, and proteinuria improved.
RESUMEN
Objective To investigate the expression of indoleamine 2,3-dioxygenase(IDO)in renal tissues of crescent nephritis and its correlation with cell proliferation and pathologic tubulointerstitial lesion.Methods Immunohistochemistry was used to detect IDO expression in renal tissues of crescent nephritis and normal renal tissues.The correlation between IDO expression and the number of proliferating cell nuclear antigen(PCNA)positive cells or pathologic tubulointerstitial lesion were analyzed.Results IDO expression was found in the renal tubular epithelial cells of crescent nephritis,while that in the normal renal tissues was negative by immunohistochemical staining.The expression of IDO protein in tubular epithelial cells showed a significantly negative correlation with the number of PCNA positive cells or tubulointerstitial lesion of crescent nephritis.Conclusion IDO may participate in the pathogenesis of crescent nephritis by inhibiting the cell proliferation.