완전 관해 20년 후에 재발한 막성신병증 1예

• Published in: The Korean journal of medicine Vol. 92; no. 3; pp. 295 - 299
• Main Authors: 박문, Moon Park, 성준민, June Min Sung, 김형영, Hung Young Kim, 김동환, Dong Hwan Kim, 김상현, Sang Hyun Kim, 박원도, Won Do Park
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 01.06.2017
• Subjects: Glomerulonephritis; Membranous; Proteinuria; Recurrence; 내과학; 단백뇨; 막성신병증; 재발
• ISSN: 1738-9364; 2289-0769
• DOI: 10.3904/kjm.2017.92.3.295

저자들은 20년 전 단백뇨 발생과 함께 신조직검사에서 막성신병증이 진단되었던 환자가, 치료 이후 단백뇨가 소실되고 완전 관해되었으며, 치료 20년 후에 다시 단백뇨의 발생과 막성신병증이 재발된 환자 1예를 경험하였기에 이를 보고하는 바이다. Membranous nephropathy is the most common pathologic lesion in adult patients with nephrotic syndrome. The cause is idiopathic, and the pathogenesis is believed to involve the deposition of immune complexes in the subepithelial tissue of the glomerular capillaries. After a period of 5 to 10 years, one-third of patients with membranous nephropathy will develop spontaneous remission, one-third will develop sustained proteinuria, and one-third will experience progression to chronic renal disease. Proteinuria may recur in patients who are in complete remission; this has been reported in approximately 26% of patients during an average of 89 months. To date, however, recurrence of membranous nephropathy has not been reported in patients who have been in complete remission for ≥ 20 years. We report herein such a case. Membranous nephropathy may recur in adult patients who are currently in the remission stage. Ongoing follow-up is therefore required, even after several years of complete remission. (Korean J Med 2017;92:295-299)