慢性Q热合并肾功能不全1例

doi:10.16138/j.1673-6087.2026.02.10

内科理论与实践 ›› 2026, Vol. 21 ›› Issue (02): 167-170.doi: 10.16138/j.1673-6087.2026.02.10

慢性Q热合并肾功能不全1例

李一林¹^,²^,^*(), 张春丽¹^,^*, 沈平雁¹, 徐静¹, 胡晓帆¹, 李娅¹()

^1. 上海交通大学医学院附属瑞金医院肾内科，上海　200025
^2. 苏州市中医医院肾内科，江苏苏州　215000

收稿日期:2025-11-11 修回日期:2026-01-26 接受日期:2026-02-10 出版日期:2026-04-25 发布日期:2026-06-15
通讯作者: 李娅 E-mail：yayayaly@126.com
作者简介:作者贡献/Authors’ Contributions李一林、张春丽负责病史资料收集、数据统计分析、作图、文章撰写；沈平雁负责病例治疗指导；徐静、胡晓帆负责肾穿刺病理；李娅负责论文审阅。
*李一林与张春丽为共同第一作者
基金资助:
瑞金医院广慈创新技术启航计划(GCQH2025143)

A case of chronic Q fever complicated with renal insufficiency

LI Yilin¹^,²^,^*(), ZHANG Chunli¹^,^*, SHEN Pingyan¹, XU Jing¹, HU Xiaofan¹, LI Ya¹()

^1. Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025,China
^2. Department of Nephrology, Suzhou Hospital of Traditional Chinese Medicine, Suzhou 215000, China

Received:2025-11-11 Revised:2026-01-26 Accepted:2026-02-10 Online:2026-04-25 Published:2026-06-15

摘要/Abstract

摘要：

慢性Q热由贝纳柯克斯体感染引起，临床病例较少，合并肾功能不全的病例报道更罕见。目前国内外关于该病的报道不多，其临床特点和发病机制尚不明确。本文报道1例临床表现为肾病综合征、肾功能受损的慢性Q热患者，肾活检提示为膜增生性肾小球肾炎，经糖皮质激素、环磷酰胺、羟氯喹联合多西环素治疗后，其肾功能得到改善。

关键词: 慢性Q热, 肾病综合征, 膜增生性肾小球肾炎, 二代测序, 多西环素, 羟氯喹

Abstract:

Chronic Q fever is caused by Coxiella burnetii infection. There are few clinical cases of chronic Q fever, and cases complicated with renal insufficiency are even more rarely reported. At present, there are few reports about this disease both domestically and internationally, and its clinical characteristics and pathogenesis remain unclear. This article reports a case of a chronic Q fever patient with clinical manifestations of nephrotic syndrome and impaired renal function, whose renal biopsy revealed membranoproliferative glomerulonephritis. After treatment with glucocorticoid, cyclophosphamide, hydroxychloroquine combined with doxycycline, the patient’s renal function improved.

Key words: chronic Q fever, nephrotic syndrome, membranoproliferative glomerulonephritis, next-generation sequencing, doxycycline, hydroxychloroquine

李一林, 张春丽, 沈平雁, 徐静, 胡晓帆, 李娅. 慢性Q热合并肾功能不全1例[J]. 内科理论与实践, 2026, 21(02): 167-170.

LI Yilin, ZHANG Chunli, SHEN Pingyan, XU Jing, HU Xiaofan, LI Ya. A case of chronic Q fever complicated with renal insufficiency[J]. Journal of Internal Medicine Concepts & Practice, 2026, 21(02): 167-170.

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参考文献 24

[1]	张启恩, 鲁志新, 韩光红. 我国重要自然疫源地与自然疫源性疾病[M]. 沈阳: 辽宁科学技术出版社, 2003.
	Zhang QE, Lu ZX, Han GH. Important natural foci and natural foci diseases in China[M]. Shenyang:Liaoning Science and Technology Publishing House, 2003.
[2]	冯晓妍, 吴敏, 罗敏. 我国Q热流行病学研究进展[J]. 医学动物防制,2010,26(3):219-220.
	Feng XY, Wu M, Luo M. Research progress of Q fever epidemiology in China[J]. J Med Pest Control,2010,26(3):219-220.
[3]	张芳, 刘增加. 我国西北部分地区Q热分子流行病学调查[J]. 中国病原生物学杂志,2011,6(3):183-185. doi: 10.13350/j.cjpb.2011.03.007
	Zhang F, Liu ZJ. Molecular epidemiological studies on Coxiella burnetii from Northwestern China[J]. Journal of Pathogen Biology,2011,6(3):183-185. doi: 10.13350/j.cjpb.2011.03.007
[4]	Raoult D, Marrie T, Mege J. Natural history and pathophysiology of Q fever[J]. Lancet Infect Dis,2005,5(4):219-226. doi: 10.1016/S1473-3099(05)70052-9
[5]	Marmion BP, Higgins FE, Bridges JB, et al. A case of subacute rickettsial endocarditis; with a survey of cardiac patients for this infection[J]. Br Med J,1960,2(5208):1264-1267.
[6]	Ferguson IC, Craik JE, Grist NR. Clinical, virological, and pathological findings in a fatal case of Q fever endocarditis[J]. J Clin Pathol,1962,15(3):235-241. doi: 10.1136/jcp.15.3.235
[7]	Dathan JR, Heyworth MF. Glomerulonephritis associated with Coxiella burnetii endocarditis[J]. Br Med J,1975,1(5954):376-377. doi: 10.1136/bmj.1.5954.376
[8]	Uff JS, Evans DJ. Mesangio-capillary glomerulonephritis associated with Q-fever endocarditis[J]. Histopathology,1977,1(6):463-472.
[9]	Perez-Fontan M, Huarte E, Tellez A, et al. Glomerular nephropathy associated with chronic Q fever[J]. Am J Kidney Dis,1988,11(4):298-306. doi: 10.1016/S0272-6386(88)80134-3
[10]	Gerlis LM, Somerville J, Dewar A, et al. Presumptive Q fever myocarditis associated with Coxiella burnetii infection of a homograft valve in the outflow tract of the right ventricle: review and case report[J]. Cardiovasc Pathol,1994,3(2):73-80. doi: 10.1016/1054-8807(94)90036-1
[11]	Vacher-Coponat H, Dussol B, Raoult D, et al. Proliferative glomerulonephritis revealing chronic Q fever[J]. Am J Nephrol,1996,16(2):159-161.
[12]	Balasubramanian R, Fournier PE, Ganesan PS, et al. Q fever endocarditis in India: a report of two cases[J]. Indian J Med Microbiol,2022,40(2):315-316. doi: 10.1016/j.ijmmb.2022.01.009
[13]	Leclerc S, Royal V, Dufresne SF, et al. Membranoproliferative glomerulonephritis in a patient with chronic Q fever[J]. Kidney Int Rep,2020,5(12):2393-2398. doi: 10.1016/j.ekir.2020.09.038
[14]	Ismayilov R, Acar BN, Kapar B, et al. Q fever endocarditis-associated immune complex-mediated proliferative glomerulonephritis: fourth case from Türkiye[J]. Mikrobiyol Bul,2023,57(2):293-300. doi: 10.5578/mb.20239924
[15]	Hou W, Yao Y, Dun D, et al. Q fever endocarditis and glomerulonephritis[J]. Kidney Int,2025,108(1):156
[16]	Coorey CP, James W, Manickavasagam V, et al. Endocapillary proliferative glomerulonephritis associated with Q fever endocarditis: a case report[J]. Clin Case Rep,2024,12(10):e9473 doi: 10.1002/ccr3.9473
[17]	Loyen M, Wiech T, Reuter S, et al. Case report: membranoproliferative glomerulonephritis associated with Q fever causing chronic endocarditis[J]. BMC Nephrol,2024,25(1):291 doi: 10.1186/s12882-024-03694-9
[18]	Yao Y, Zhao H, Lu H, et al. Crescentic glomerulonephritis and portal hypertension with chronic Q fever: a case report and comprehensive literature review[J]. Infect Drug Resist,2024,17:4599-4605. doi: 10.2147/IDR.S495710
[19]	Thanamayooran A, Tennankore K, Geldenhuys L, et al. Questioning the diagnosis:an educational case report[J]. Can J Kidney Health Dis,2024,9:20543581221097749.
[20]	Kersh GJ. Antimicrobial therapies for Q fever[J]. Expert Rev Anti Infect Ther,2013,11(11):1207-1214. doi: 10.1586/14787210.2013.840534
[21]	Li D, Liu H, Liu M, et al. Delayed diagnosis of acute Q fever, China[J]. Emerg Infect Dis,2022,28(12):2580-2582. doi: 10.3201/eid2812.221118
[22]	杨睿, 程玖玲, 孟洋洋, 等. 11例散发性急性Q热病例临床特征分析[J]. 中华急诊医学杂志,2023,32(7):973-979.
	Yang R, Cheng JL, Meng YY, et al. Analysis of clinical characteristics of 11 sporadic acute Q fever cases[J]. Chin J Emerg Med,2023,32(7):973-979.
[23]	Jansen AFM, Raijmakers RPH, Keijmel SP, et al. Autoimmunity and B-cell dyscrasia in acute and chronic Q fever: a review of the literature[J]. Eur J Intern Med,2018,54:6-12. doi: 10.1016/j.ejim.2018.06.007
[24]	Pradeep J, Anitharaj V, Sangeetha B. Human rickettsial infections in India - a review[J]. J Vector Borne Dis,2024,61(1):5-22.

慢性Q热合并肾功能不全1例

A case of chronic Q fever complicated with renal insufficiency

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