症例報告:II型アバーチ奇形を伴うIgA腎症の稀な症例
Wenya Cao1, Xiaoli Guo1, Xue Zhao1
1Department of Nephrology, The Third Hospital of Xi'an, Affiliated Hospital of Northwest University, Xi'an, China.
Abstract:
Abernethy malformation is a rare congenital vascular anomaly involving extrahepatic portosystemic shunting, with only a handful of reported cases coexisting with IgA nephropathy. We present a case of a patient who initially manifested with proteinuria and hematuria, and later developed hepatic encephalopathy, prompting vascular imaging that identified a type II Abernethy malformation characterized by an extrahepatic portocaval shunt. A diagnosis of type II Abernethy malformation was established. The patient underwent laparoscopic partial shunt disconnection, which led to a marked reduction in proteinuria (from 0.8-2.1 g/d to 0.19-0.29 g/d). This case, along with previous reports, suggests that portosystemic shunting in Abernethy malformation may be a pathogenic factor in IgA nephropathy. Surgical correction of the shunt may confer renal benefits in selected cases and deserves further investigation.
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