@article{oai:dmu.repo.nii.ac.jp:00005271,
 author = {藤田, 雄治 and 加納, 優治 and 鷹木, 雄飛 and 林, 周次郎 and 吉原, 重美 and Fujita, Yuji and Kano, Yuji and Takagi, Yuhi and Hayashi, Shujiro and Yoshihara, Shigemi},
 issue = {2},
 journal = {Dokkyo Journal of Medical Sciences},
 month = {Dec},
 note = {症例は9歳女児．発熱，特徴的皮疹，自己抗体などの検査所見から小児全身性エリテマトーデス（SLE）と診断した．入院時の尿所見は軽度蛋白尿（尿蛋白/クレアチニン比0.41g/gCr）のみで血尿や細胞性円柱はみられなかった．腎生検の結果はISN/RPS分類でclassⅢA＋Ⅴであり，重症ループス腎炎（LN）を有する高リスク群であった．ステロイドパルス2コースにミコフェノール酸モフェチルの併用で寛解導入を行い，治療経過は良好である．SLEでは尿検査異常がなし〜軽微で腎機能障害もないが，病理学的にLNが存在するsilent LNが知られている．重症LNは腎予後・生命予後に関わるため，LNの有無や重症度の把握，その結果に基づいた適切な寛解導入および維持療法が重要である．尿所見が軽微であっても積極的に腎生検による病理学的評価を行うべきである．, A nine-year-old girl was diagnosed with systemic lupus erythematosus based on characteristic skin findings and laboratory findings such as autoantibodies. Urinary analysis showed a urinary protein and creatinine ratio of 0.41 g/g and no hematuria or cellular casts were observed. Renal biopsy showed an International Society of Nephrology （ISN）/Renal Pathology Society （RPS） Class IIIA and V, indicating a high-risk group with severe lupus nephritis （LN）. She was treated with methylprednisolone pulse combined with mycophenolate mofetil as induction therapy. Silent LN, which is pathologically present without abnormal urinalysis, is known. Since severe LN is related to renal and life prognosis, it is important to understand the presence or absence of LN and its severity, in order to provide appropriate induction and maintenance therapy based on these results. Pathological evaluation by renal biopsy should be aggressively performed even if urinary findings are slightly abnormal.},
 pages = {102--106},
 title = {尿所見が軽微であったが重症ループス腎炎（ⅢA＋Ⅴ型）を有した全身性エリテマトーデスの9歳女児},
 volume = {49},
 year = {2022}
}