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本文报道3例经肾活检确诊的弥漫性间质性肾结核患者。均为英籍移民,2例来自印度,1例来自非洲。男2例,女1例,年龄分别为21、50及31岁。均有肾外活动性结核,其中2例为肺结核,1例为腹膜结核。所有病例就诊时已有肾功能衰竭,血浆尿素及肌酐分别为39、8.1、5.2mmol/L 和1.62、0.3、0.14mmol/L。唯一的泌尿系症状为夜尿。晨尿结核杆菌培养阴性,静脉肾盂造影均正常。3例都因持续性肾功能衰竭经肾活检而确诊,其组织学特征为广泛性间质纤维化。淀粉染色、C_3、C_4、抗核因子均正常,电镜及荧光免疫染色在肾小球及其它部位均未发现免疫复合物沉着,说明肾功能衰竭并非结核感染引起的淀粉样变或免疫性肾小球肾炎所致。经积极抗结核治疗后,所有病例的肾外结核均治愈。例1肾功能衰竭持
This article reports 3 cases of diffuse interstitial renal tuberculosis diagnosed by renal biopsy. All are British immigrants, two from India and one from Africa. There were 2 males and 1 females, aged 21, 50 and 31 years old respectively. There are extra-renal tuberculosis, of which 2 cases of tuberculosis, 1 case of peritoneal tuberculosis. Renal failure was observed in all cases, and plasma urea and creatinine were 39, 8.1, 5.2 mmol / L and 1.62, 0.3, 0.14 mmol / L, respectively. The only urinary symptoms are nocturia. Morning urine M. tuberculosis culture negative, intravenous pyelography were normal. All 3 patients were diagnosed with renal failure due to persistent renal failure, and their histological features were extensive interstitial fibrosis. Starch staining, C_3, C_4, anti-nuclear factor were normal, electron microscopy and fluorescent immunostaining in the glomerular and other parts of the immune complex not found calm, indicating that renal failure is not caused by tuberculosis infection of amyloidosis or immune kidney Ball nephritis caused. After active anti-TB treatment, all cases of extra-renal tuberculosis were cured. Example 1 Renal failure hold