Rhupus综合征合并抗中性粒细胞胞浆抗体及冷球蛋白血症引起的肾损害
Renal damage caused by Rhupus syndrome associated with anti-neutrophil cytoplasmic antibodies vasculitis and cryoglobulinemia

总结北京大学人民医院收治的1例出现复杂肾损害的Rhupus综合征患者的临床及病理特点，并对其进行文献复习。患者为中年女性，类风湿关节炎起病在先，系统性红斑狼疮临床表现不典型，伴抗中性粒细胞胞浆抗体（anti-neutrophil cytoplasmic antibodies，ANCA）阳性，血冷球蛋白检测阳性。患者进行了肾活检，病理提示为狼疮性肾炎及ANCA相关血管炎特征，电镜检查证实伴有冷球蛋白血症肾损害。研究提示Rhupus综合征肾损害临床表现复杂，容易漏诊、误诊，肾活检病理是明确诊断的重要手段。
We analyzed the clinicopathological characteristics of one patient with Rhupus syndrome associated nephropathy in Peking University People’s Hospital, and reviewed the related literature. The patient was a middle aged female. She developed rheumatoid arthritis first, and then manifested mild systemic lupus erythematosus together with positive anti-neutrophil cytoplasmic antibodies (ANCA) and cryoglobulinemia several years later. The renal biopsy was performed and manifested as lupus nephritis. The transmission electron microscopy revealed cryoglobulinemia associated renal damage. This report shows that the clinicopathological characteristics in patients with Rhupus syndrome associated nephropathy are complicated. The renal pathology can be used as a diagnostic tool.