李晶晶,杜鹏鸿,贺立娟,申玉兰

病史摘要患者丁XX，女性，34岁，因“下肢水肿20天”于2024年2月19日入院。患者20天前无诱因出现双下肢水肿，伴尿中泡沫增多，化验尿常规：尿蛋白4+，24小时尿蛋白定量7.9g，考虑肾小球微小病变（MCD）可能，予静脉应用激素3天，后改为口服激素，化验尿汞明显升高，行肾穿刺活检确诊肾小球微小病变，确诊汞中毒性肾病微小病变性肾小球肾炎，予驱汞、激素治疗，监测尿汞逐渐恢复正常。

肾小球微小病变；汞中毒；肾病

[1] PelclováD,Lukás E,Urban P,et al.Mercury intoxication from skin ointment containing mercuric ammonium chloride[J].Int Arch Occup Environ Health,2002,75:S54-59. [2] Sumathi T,Shobana C,Christinal J,et al.Protective effect of Bacopa monnieri on methyl mercury-induced oxidative stress in cerebellum of rats[J].Cell Mol Neurobiol,2012,32(6):979-987. [3] Yawei S,Jianhai L,Junxiu Z,et al.Epidemiology,clinical presen tation,treatment,and follow-up of chronic mercury poisoning in China:a retrospective analysis[J].BMC Pharmacol Toxicol,2021, 22(1):25. [4] Miller S,Pallan S,Gangji AS,et al.Mercury-associated ne phrotic syndrome:a case report and systematic review of the liter ature[J].Am J Kidney Dis,2013,62(1):135-138. [5] Orr SE,Bridges CC.Chronic Kidney disease and exposure to nephrotoxic metals[J].Int J Mol Sci,2017,18(5):1039. [6] 马健飞,周希静.氯化汞诱导大白鼠双相自身免疫性肾小球肾炎[J].中国医科大学学报,1992,021(5):368-371. [7] 中国成人肾病综合征免疫抑制治疗专家组.中国成人肾病综合征免疫抑制治疗专家共识[J].中华肾脏病杂志,2014,30(6):467.

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