小结
定义
病史和体格检查
关键诊断因素
- 尿量减少
- 咯血
- 水肿
其他诊断因素
- 男性
- 20至30岁或60至70岁
- 呼吸短促
- 咳嗽
- 发热
- 恶心
- 肺部听诊湿啰音
危险因素
- HLA-DRB1或DR4
诊断性检查
首要检查
- 肾功能检查
- 肾脏活检
- 抗肾小球基底膜(抗-GBM)抗体滴度
- 抗中性粒细胞胞质抗体 (ANCA)
- 血清补体(C3和C4)
- 抗核抗体
- 冷球蛋白
- 肝炎病毒检测
- 抗链球菌溶血素O滴度
- 凝血筛查
治疗流程
可逆性肾病或任何肺部受累
不可逆性肾病
撰稿人
作者
Richard G. Phelps, BChir
Senior Lecturer and Honorary Consultant in Nephrology
University of Edinburgh and Edinburgh Royal Infirmary
Edinburgh
UK
利益声明
RGP has helped Genzyme develop educational materials for neurologists regarding the increased risk of Goodpasture's disease with alemtuzumab use. RGP has published an article on post-alemtuzumab nephritis in which employees of Genzyme were co-authors.
鸣谢
Dr Richard G. Phelps would like to gratefully acknowledge Professor Andre A. Kaplan and Dr Michael S. Gersch, previous contributors to this topic. AAK has received honoraria in 2013 to speak about plasma exchange from Gambro and Alexion (Gambro manufactures products for plasma exchange and Alexion manufactures a complement cascade inhibitor). MSG declares that he has no competing interests.
同行评议者
Dorin-Bogdan Borza, PhD
Assistant Professor of Medicine
Division of Nephrology
Department of Medicine
Vanderbilt University School of Medicine
Nashville
TN
利益声明
DBB declares that she has no competing interests.
鉴别诊断
- 系统性红斑狼疮
- 肉芽肿性多血管炎（韦格纳肉芽肿）
- 显微镜下多发性血管炎
更多 鉴别诊断指南
- 治疗性血浆置换在临床实践中使用的指南
- KDIGO 肾小球肾炎临床实践指南
更多 指南
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