Síndrome nefrótico e injuria renal aguda con microangiopatía trombótica en mujer con enfermedad celíaca: Caso clínico

• Jorge Vega ^[1] ; Rienzi Díaz ^[2] ; Gonzalo R Méndez ^[3] ; Helmuth Goecke ^[1]
  1. [1] Hospital Naval Almirante Nef

     Hospital Naval Almirante Nef

     Viña del Mar, Chile

     
  2. [2] Universidad de Valparaíso

     Universidad de Valparaíso

     Valparaíso, Chile

     
  3. [3] Pontificia Universidad Católica de Chile

     Pontificia Universidad Católica de Chile

     Santiago, Chile

     

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• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 141, Nº. 3, 2013, págs. 381-387
• Idioma: español
• Títulos paralelos:
  • Nephrotic syndrome and acute kidney injury associated with celiac disease: Report of one case
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• Resumen

  • Celiac disease may be associated with other autoimmune diseases and exceptionally with glomerulopathies and nephrotic syndrome. Associations have been reported with IgA nephropathy, membranoproliferative glomerulonephritis, membranous glomerulopathy and minimal change disease. We report a 63-year-old woman who simultaneously presented with massive nephrotic syndrome (proteinuria 46 g/day) and cachexia due to a malabsorption syndrome secondary to celiac disease. The course of her diseases was complicated with cardiomyopathy due to severe malnutrition, septic shock, acute kidney injury that required dialysis for seven weeks and severe hypertension. A renal biopsy showed a membranoproliferative pattern of injury secondary to a thrombotic microangiopathy and diffuse podocyte damage. Four years later, the patient was in good general health, the glomerular filtration rate was 30 ml/min/1.73m² and there was non-nephrotic proteinuria.