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交叉的自身免疫:ANCA和抗GBM在患有Sjögren病的患者身上重叠

Mayra Estacio¹, Joaquín Rodelo-Ceballos^1,2, Ligia Calderon²

¹Facultad de Ciencias de la Salud, University of Antioquia, Medellín, Colombia, udea.edu.co.

Case reports in nephrology

|March 2, 2026

概括

该病例详细介绍了一种罕见的自身免疫重叠综合征,涉及Sjögren病患者的抗中性粒细胞质抗体 (ANCA) 和抗质底膜 (anti-GBM) 抗体,导致严重损伤.

科学领域:

腎臟病學 (nephrology) 是一種醫學專業.
类风湿病学类风湿病学
免疫学免疫学免疫学

背景情况:

自身免疫重叠综合征,其特征是同时存在的抗中性粒细胞质抗体 (ANCA) 和抗质底膜 (anti-GBM) 抗体,代表了一种罕见但严重的疾病.
这种双重抗体阳性可以导致快速进展的淋巴结核突炎,往往导致脏结果不佳.
在患有潜在的全身性自身免疫性疾病的患者中,如Sjögren病,由于重叠的免疫病原性机制,诊断是复杂的.

研究的目的:

突出与双重ANCA和抗GBM抗体阳性相关的诊断和治疗挑战.
强调早期识别和个性化治疗在管理这种罕见的自身免疫重叠综合征方面的重要性.
为了强调需要在患有自身免疫性疾病的患者中具有高可疑指数,同时呈现功能障碍.

主要方法:

一个62岁的妇女的病例报告,患有初级的Sjögren病,呈现急性损伤.
血清学评估显示了高位的骨髓氧化酶 (MPO) -ANCA,抗GBM抗体,ANA和抗Ro/La抗体.
脏活检证实了新月状球炎与线性IgG沉积和慢性变化.

主要成果:

该患者对MPO-ANCA和抗GBM抗体表现出双重阳性,以及其他自身免疫标志物.
脏活检显示严重的质膜炎与晚期纤维化,表明预后不佳.
最初使用皮质类固醇进行免疫抑制治疗,但进一步的治疗因疾病严重程度而受到限制,需要透析.

结论:

在Sjögren病的背景下,双ANCA和抗GBM抗体阳性呈现出重大诊断和治疗障碍.
快速识别和量身定制的干预措施对于优化结果至关重要,尽管脏的预后往往很差.
在患有全身自身免疫疾病的患者中检测这种罕见的重叠综合征时,高度的怀疑指数至关重要.

关键词:

安卡 ANCA 的时间.斯约格伦病是Sjögren的疾病.这是一个反GBMM的反GBM.双重积极性的双重积极性.快速渐进的质膜神经炎.

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