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Medical Principles and Practice. 2008; 17 (3): 255-257
em Inglês | IMEMR | ID: emr-104586

RESUMO

To report a case with the diagnosis of IgM nephropathy and familial Mediterranean fever [FMF]. Clinical Presentation and Intervention: A 9-year-old boy was admitted to our hospital with recurrent abdominal pain since the age of 4 years. Laboratory investigations revealed a sedimentation rate of 88 mm/h, C-reactive protein: 83.2 mg/l [0-10 mg/l], white blood cell count: 12,700/mm3, fibrinogen: 622 mg/dl [200-400 mg/dl] and serum amyloid A: 186 mg/l [0-5.8 mg/l]. Urinalysis revealed +2 proteinuria. A 24-hour urinary protein excretion was 12 mg/m2/h. M694V homozygous mutation was identified in exon 10. Percutaneous renal biopsy showed mesangial cell proliferation and increased mesangial matrix in the glomeruli, without amyloid accumulation. Immunofluorescence study showed IgM [+1] and C1q [+1] deposits. Treatment with 1 mg/day colchicine was started. Six weeks later, proteinuria had disappeared and the patient was asymptomatic. This case illustrates the unusual association of FMF with non-amyloid glomerulopathy. Glomerular diseases such as IgM nephropathy may be seen as a manifestation of FMF


Assuntos
Humanos , Masculino , Febre Familiar do Mediterrâneo/diagnóstico , Glomerulonefrite/complicações , Glomerulonefrite/diagnóstico , Imunoglobulina M/imunologia , Moduladores de Tubulina , Colchicina
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