CAJ | 학술논문

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。
총결북경대학인민의원수치적1례출현복잡신손해적Rhupus종합정환자적림상급병리특점，병대기진행문헌복습。환자위중년녀성，류풍습관절염기병재선，계통성홍반랑창림상표현불전형，반항중성립세포포장항체（ anti-neutrophil cytoplasmic antibodies ，ANCA）양성，혈랭구단백검측양성。환자진행료신활검，병리제시위랑창성신염급ANCA상관혈관염특정，전경검사증실반유랭구단백혈증신손해。연구제시Rhupus종합정신손해림상표현복잡，용역루진、오진，신활검병리시명학진단적중요수단。
SUMMARY We analyzed the clinicopathological characteristics of one patient with Rhupus syndrome as-sociated nephropathy in Peking University People ’s Hospital, and reviewed the related literature .The pa-tient was a middle aged female .She developed rheumatoid arthritis first , and then manifested mild sys-temic 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 .