Dab tsi yog Qhov Zoo Tshaj Plaws Uas Mob Raum Raum Raug Mob Los Ntawm Mob Pyelonephritis?

Hu rau:joanna.jia@wecistanche.com/ WhatsApp: 008618081934791

Paub meej: Tus neeg mob yog ib tug txiv neej muaj hnub nyoog 38- xyoo uas muaj xeev siab thiab kub taub hau rau ob peb hnub thiab nthuav tawm nrog mob nraub qaum, oliguria, thiab pyuria, qhia tias mob pyelonephritis (mob hnyavpyelonephritis mob). Nws qhiamob hnyavraumraug mobnrog ob tograumo thiab tau siv cov tshuaj nonsteroidal anti-inflammatory (NSAIDs).mob hnyavraumraug mobinduced los ntawmmob hnyavpyelonephritis mobtau lees paub los ntawm araumbiopsy. Covmob hnyavraumraug mobtau zoo kho nrog tshuaj tua kab mob. Kev tshawb nrhiav ntawm cov ntaub ntawv cuam tshuam rau cov lus ceeb toom ntawm histopathologically-pov thawjmob pyelonephritis tshwm simmob hnyavmob hnyavraumraug mobqhia tias cov yam ntxwv tseem ceeb yog ob sabraumo nrog pyuria yam tsis muaj casts. Oligoanuria feem ntau cuam tshuam nrogmob pyelonephritis tshwm simmob hnyavmob hnyavraumraug mob, thiab kev siv NSAID tej zaum yuav muaj kev pheej hmoo. Kev kho mob sai sai raws li kev kho mob cov yam ntxwv ntawm mob pyelonephritis inducedmob hnyavraumraug mobtuaj yeem txhim kho covraumqhov tshwm sim.

Ntsiab lus:mob raum raug mob, raum, mob hnyavpyelonephritis mob

cistanchekho tauraumkab mobtxhim kho lub raum ua haujlwm

Taw qhia

Mob hnyavpyelonephritis mobyog cov kab mob hauv zej zog feem ntau ntawm cov kab mobraum(1). mob hnyavpyelonephritis mobmuaj peev xwm ua rau tuag taus vim sepsis lossis septic shock, uas yuav ua raumob hnyavraumraug mob(mob hnyavraumraug mob) vim mob tubular necrosis. Mob hnyavmob hnyavraumraug mob[ txhais tiasLub raumKab Mob Txhim Kho Ntiaj Teb Kev Ua Tau Zoo (KDIGO) theem 2 lossis 3 (2)] tshwm sim los ntawmmob hnyavpyelonephritis mobnws tus kheej yog tsawg. Tus kab mob histopathology ntawm tus mob pyelonephritis yog ib tug kab mob tubulointerstitial uas qhia patchy infiltration ntawm lubrauminterstitium thiab tubules los ntawm inflammatory hlwb, nrog tubular necrosis thiab pus cast tsim. Focal tsub zuj zuj ntawm leukocytes yuav ua rau abscess tsim ntawm qhov chaw ntawm qhov puasraumntaub so ntswg. Kev kho mob thaum ntxov ntawmmob hnyavpyelonephritis mobtej zaum yuav zam kev tuag thiab txhim kho lubraumkev kwv yees.

Mob hnyavpyelonephritis mobqhia cov tsos mob thiab cov tsos mob ntawm ob qho tib si kab mob thiab lub zais zis o. Txawm li cas los xij, txog li 20 feem pua ​​​​ntawm cov neeg mob tsis muaj cov tsos mob ntawm lub zais zis. Cov kev nthuav qhia kev kho mob thiab cov kab mob hnyav sib txawv, xws li mob me me nrog lossis tsis ua npaws mus rau septic shock (4, 5). Nws tsis zoo li ob leeglub raumyuav kis tau tib lub sijhawm. Yog li,mob pyelonephritis tshwm simmob hnyavmob hnyavraumraug mobNws tsis tshua muaj tshwm sim thaum tsis muaj kev sib koom ua ke ntawm urinary tract obstruction, thiab nws yuav nyuaj rau kev soj ntsuam kom paub meej tiasmob pyelonephritis tshwm sim mob hnyavraumraug mob.

Peb ntawm no qhia txog qhov tsis tshua muaj tshwm sim ntawmmob pyelonephritis tshwm simmob hnyavmob hnyavraumraug mobuas tau lees paub los ntawm araumbiopsy. Peb tau tshuaj xyuas cov ntaub ntawv Askiv ntsig txog rau cov neeg mob nrogmob pyelonephritis tshwm simmob hnyavmob hnyavraumraug mob, uas tau kho nyob rau hauv 50 xyoo dhau los, thiab tshuaj xyuas cov yam ntxwv ntawm kev kho mob.

Case Report

Ib tug txiv neej muaj hnub nyoog {{{0}}}xyoo-laus tau nthuav tawm rau peb chav haujlwm nrog xeev siab thiab tsis qab los noj mov, uas tau mob siab rau 4 hnub ua ntej nws nkag mus, thiab kub taub hau ntawm 39 degree thiab mob caj pas, uas tau mob siab rau 3 hnub ua ntej nws nkag. Nws tau noj tramadol hydrochloride, acetaminophen, thiab loxoprofen sodium hydrate raws li xav tau. Ib hnub ua ntej tus neeg mob nkag mus, nws tau tshwm sim ntawm chav kho mob xwm txheej ceev hauv peb lub tsev kho mob, yws txog cov tsos mob uas tau hais los saum no. Tom qab rov qab los tsev, nws pib mob plab plab thiab sab laug mob sab laug thiab raug xa mus rau peb lub tsev kho mob. Nws keeb kwm yav dhau los suav nrog Kawasaki kab mob thiab cerebral infarction nrog sab laug hemiplegia uas tsis paub ua rau thaum muaj hnub nyoog 11 xyoos. Nws tus kab mob Kawasaki tau tsis ua haujlwm txij li lub sijhawm ntawd. Nws tau noj carbamazepine, trihexyphenidyl hydrochloride, thiab tizanidine hydrochloride rau kev tswj cov tsos mob tom qab cerebral infarction. Nws kuj tau noj 200 mg/hnub ntawm celecoxib rau qhov mob hauv nws sab laug sab laug rau 10 hnub ua ntej nkag. Txawm hais tias nws muaj cerebral infarction, tus neeg mob tsis tau kuaj pom tias muaj lub zais zis neurogenic thiab nws tsis muaj qhov cuam tshuam rau cov zis ua ntej nws nkag. Nws tsis haus cawv thiab tsis kam siv tshuaj yeeb. Cov ntshav creatinine qib ntawm 0.66 mg/dL tau sau tseg 6 xyoo dhau los. Kev kuaj lub cev ntawm kev nkag tau qhia cov hauv qab no: ceeb toom; qhov siab, 165. {41}} cm; lub cev hnyav, 75.0 kg; lub cev kub, 38.5 degree; ntshav siab, 127/87 mmHg; lub plawv dhia, 107 neeg ntaus / min; oxygen saturation, 99 feem pua. Palpation ntawm nruab nrab mus rau sab laug sab hauv plab yog mob, thiab rhiab tshwm sim nyob rau hauv sab laug costovertebral lub kaum sab xis. Spastic sab laug hemiplegia tau pom. Kev kuaj zis qhia tau cov txiaj ntsig hauv qab no: pH 5.0; ntshav tsis zoo occult; 3 ntxiv protein; 1 ntxiv rau leukocyte esterase; zoo nitrites; 1-4 cov qe ntshav liab (RBCs)/high-power field; 30-49 cov qe ntshav dawb (WBCs)/high-power field; muaj cov kab mob; thiab tsis muaj cov kab mob pathological. Cov tshuaj urinary tau nthuav tawm cov kev tshawb pom hauv qab no: cov protein, 0.91 g / g creatinine; N-acetyl{32}}D-glucosaminidase, 37.1 U/L; 2-microglobulin, 1.4210 ug / L; thiab alpha 1- microglobulin, 51.0 mg/L. Kev soj ntsuam ntshav qhia cov kev tshawb pom hauv qab no: hemoglobin, 14.7 g / dL; WBC suav, 24,400/μL; platelet suav, 155,{47}}/μL; albumin, 2.5 g / dL; ntshav urea nitrogen, 49.3 mg / dL; creatinine, 2.67 mg / dL; hemoglobin A1c, 5.6 feem pua; Na, 128 mEq/L; thiab K, 3.5 mEq/L. Cov tshuaj tiv thaiv kab mob muaj raws li hauv qab no: C-reactive protein, 31.66 mg / dL; ib txwm ntxiv 3 thiab 4 qib; kab mob siab B thiab C serology, tsis zoo; anti-streptolysin O titer, ib txwm; anti-nuclear antibody, tsis zoo; thiab anti-DNA antibody, tsis zoo. Lub hauv siab X-ray pom lub ntsws li qub. Kev suav tomography pom ob sabraumkev loj hlob tsis muaj hydronephrosis lossis cov tsos mob ntawm papillary necrosis (Daim duab 1a).

Peb tus neeg mob tau kub taub hau, mob nraub qaum, oliguria, pyuria, bacteriuria, nitrites hauv nws cov zis, leukocytosis, thiab qib siab C-reactive protein, uas qhia tiasmob hnyavpyelonephritis mobyog ib qho kev kuaj mob uas tsim nyog thaum nkag; Yog li, ceftriaxone sodium (2 g txhua 24 teev) tau muab tso rau hauv txoj hlab ntshav. Txawm tias nws qhiamob hnyavraumraug mobnrog oliguria tsis muaj hypotension thiab nws cov fractional excretion ntawm Na yog 0.01 feem pua, txaus hydration tsis nce nws cov zis ntim thiab nws cov ntshav creatine tsis txo, txiav tawm pre-raummob hnyavraumraug mobib leeg. Hloov chaw, nws cov ntshav creatinine tau nce los ntawm 2.67 mg / dL rau 5.22 mg / dL nyob rau hnub thib ob ntawm kev nkag. Txawm hais tias nws cov ntshav creatinine nce siab, araumbiopsy tau ua nyob rau hnub 4 ntawm kev lees paub kom paub meej qhov ua raumob hnyavraumraug mob.

Covraumbiopsy qhia thoob ntiaj teb sclerosis hauv 1 ntawm 23 glomeruli. Qee cov glomeruli tau pom me me ntawm cov cell infiltration, suav nrog polymorphonuclear leukocytes (Fig. 2a). Muaj ib qho me me mus rau nruab nrab ntawm kev sib xyaw ntawm cov cell infiltration, muaj li ntawm polymorphonuclear leukocytes, lymphocytes, thiab tsawg eosinophils, nyob rau hauv zonal cheeb tsam ntawm lub tubulointerstitium nrog patchy tubular epithelial cell flattening thiab atrophy (Fig. 2b). Pus casts tau pom nyob rau hauv cov tubules (Fig. 2b, c). Ib qho me me ntawm arteriolar hyalinosis tau pom. Tsis muaj vasculitis nyob rau hauv ib theem ntawm cov hlab ntsha. Ib qho kev tshawb fawb immunofluorescence tsis zoo rau IgG, IgA, IgM, C3, thiab C1q. Cov kev tshawb pom no tau lees paub tiasmob hnyavraumraug mobFeem ntau yog tshwm sim los ntawm mob interstitial nephritis (AIN) vim yogmob hnyavpyelonephritis mob.

Cov qib serum-dawb kappa thiab lambda lub teeb saw theem, myeloperoxidase- thiab proteinase 3-anti-neutrophil cytoplasmic antibody qib, thiab anti-glomerular basement membrane (GBM) antibody qib tau tshaj tawm tias nyob rau hauv ib txwm muaj. Txawm hais tias tsis muaj kab mob loj hlob hauv cov zis thiab ntshav kab lis kev cai, tej zaum yog vim kev siv tshuaj tua kab mob yav dhau los, kev kho tshuaj tua kab mob nrog ceftriaxone sodium tau txuas ntxiv rau 14 hnub ntxiv rau daptomycin (700 mg txhua 48 teev intravenously). Tus neeg mob cov ntshav creatinine qib nce mus rau 1.60 mg / dL nyob rau hnubraumbiopsy thiab maj mam txo mus rau 0.70 mg/dL nyob rau hnub 15 ntawm kev nkag. Kev soj ntsuam tom qab ultrasound pom tsis muaj cov zis seem hauv lub zais zis tom qab tso zis. Kev suav tomography qhia tau tias ob toglub raumyog qhov loj me uas tsis muaj papillary necrosis ntawm 2 lub hlis tom qab tso tawm (Daim duab 1b).

Kev sib tham

Peb tau ntsib ib rooj plaub tsis tshua muaj nrogmob hnyavpyelonephritis mobinduced hnyavmob hnyavraumraug mobuas tau lees paub los ntawm araumbiopsy. Mob memob hnyavraumraug moblos ntawm kev mob ntsig txog hemodynamics yog tshwm sim hauvmob hnyavpyelonephritis mobthiab daws sai nrog kev kho mob. Txawm li cas los xij, hnyav heevmob hnyavraumraug mobthaum tsis muaj kev sib koom ua ke ntawm cov urinary obstruction yog tsawg. Peb cov ntaub ntawv cuam tshuam nrog tus txiv neej hnub nyoog nruab nrab uas tau nthuav tawm cov tsos mob ntawm kev cai lij choj thiab leej twg siv NSAIDs; nwsraumkev ua haujlwm tsis zoo tom qab 24 teev tom qab siv tshuaj tua kab mob nrog dej txaus. Yog li, peb xav tias lwm yam ua raumob hnyavraumraug mob(dua limob hnyavpyelonephritis mobinducedmob hnyavraumraug mob) yuav tsum tau txiav txim siab txij li nws tau tshaj tawm tiasmob hnyavpyelonephritis mobCov neeg mob uas tsis muaj cov kab mob urinary ob leeg yuav zoo dua li ntawm 24 mus rau 48 teev tom qab siv tshuaj tua kab mob.

Cov yam ntxwv ntawm cov neeg laus muaj mob hnyavmob hnyavraumraug mobtshwm sim los ntawmmob hnyavpyelonephritis mobtsis muaj urinary obstruction, ib leegraum, los yog mobraumkab mob (CKD), uas tau tshaj tawm nyob rau hauv cov ntaub ntawv Askiv uas cuam tshuam los ntawm 1969 txog 2019 tau qhia hauv Table. Mob hnyavmob hnyavraumraug mobtau txhais tias yog KDIGO theem 2 lossis 3. Txawm li cas los xij, tusmob hnyavraumraug mobtheem tsis tuaj yeem lees paub meej meej vim muaj cov ntaub ntawv tsawg uas muaj nyob rau qee kis.mob pyelonephritis tshwm sim mob hnyavraumraug mobtau ua pov thawj los ntawm histopathology lossis los ntawm chav kho mob nrog tshuaj tua kab mob. Tag nrho ntawm nees nkaum-rau qhov xwm txheej (T-pab pawg) tau tshaj tawm nyob rau kwv yees li ntawm 50- xyoo. Ntawm lawv, 19 tus neeg mob tau pov thawj histopathology (H-group). Qhov xwm txheej ntawmmob hnyavraumraug mobtheem 3 (serum creatinine 4.0 mg/dL los yograumreplacement therapy) was 84.6% in the T-group and 89.4% in H-group. Female patients accounted for 61.5% of the patients in the T-group and 63.1% of the patients in the H-group. The mean ages were 53.8 years in the T-group and 55.1 years in the H group. The analysis of available data showed that the incidence of oligoanuria was 46.1% in the T-group and 52.5% in the H-group. The rates of pyuria, which was defined as a urine WBC count of >5/high-power field lossis dipstick positivity rau leukocyte esterase, thiab tsis muaj pathologic casts yog 73. Qhov tshwm sim ntawm ob sab ob lub raum o ntawm cov duab yog 61.5 feem pua ​​​​hauv T pawg thiab 68.4 feem pua ​​​​hauv H pawg. Cov zis thiab/los yog ntshav tau zoo rau E. coli hauv 73.0 feem pua ​​​​ntawm cov neeg mob hauv ob pawg. Ob leeg ntshav thiab zis tau zoo rau Klebsiella hauv 15.3 feem pua ​​​​ntawm cov neeg mob hauv pawg T thiab 21.0 feem pua ​​​​ntawm cov neeg mob hauv pawg H. Cev xeeb tub, indwelling catheter, immunocompromised status, thiab nonsteroidal anti-inflammatory tshuaj (NSAID) / analgesic siv tau tshaj tawm raws li cov yam ntxwv predisposing. NSAIDs tau siv hauv 30.7 feem pua ​​​​ntawm cov neeg mob hauv pawg T thiab 26.3 feem pua ​​​​ntawm cov neeg mob hauv pawg H. Tag nrho ntawm 38.4 feem pua ​​​​ntawm cov neeg mob hauv pawg T thiab 36.8 feem pua ​​​​ntawm cov neeg mob hauv pawg H tau zoo los ntawmmob hnyavraumraug mob; 38.4 feem pua ​​​​ntawm cov neeg mob hauv pawg T thiab 31.5 feem pua ​​​​ntawm cov neeg mob hauv H-pawg pom tias muaj kev txhim kho ntawmmob hnyavraumraug mobtab sis tsim CKD; 11.5 feem pua ​​​​ntawm cov neeg mob hauv ob pab pawg tau los ua kev lim ntshav, thiab 11.5 feem pua ​​​​ntawm ob pawg neeg tuag. Raws li, cov yam ntxwv tseem ceeb ntawmmob pyelonephritis tshwm sim mob hnyavraumraug mobyog pyuria tsis muaj casts thiab ob tograumloj. Ob tograumo tuaj yeem tshwm sim los ntawm interstitial infiltration, edema, thiab cov kua paug tawm hauv cov tubules ntawm ob lub raum kab mob. Oligoanuria feem ntau cuam tshuam. Kev siv NSAID yog qhov muaj feem pheej hmoo raumob pyelonephritis tshwm simmob hnyavmob hnyavraumraug mob. Txawm li cas los xij, kev sib raug zoo ntawm kev siv NSAID thiab mob hnyavpyelonephritis tshwm simmob hnyavmob hnyavraumraug mobtsis paub. NSAIDs tuaj yeem ncua qhov kev nthuav qhia ntawmmob hnyavpyelonephritis mobcov neeg mob vim yog ib ntus txo qhov mob thiab kub taub hau, thiab yog li ncua kev tswj kom tsim nyog. Tsis tas li ntawd, NSAIDs tuaj yeem txo qhov glomerular pom tus nqi, pab txhawb kev txhim kho ntawmmob pyelonephritis tshwm simmob hnyavmob hnyavraumraug mob. Peb cov ntaub ntawv featured yam ntxwv ntawmmob hnyavpyelonephritis mobinduced hnyavmob hnyavraumraug mob, suav nrog kev siv NSAID, oliguria, pyuria yam tsis muaj kev cuam tshuam, thiab ob sabraumloj. Peb tsis tau kuaj xyuas tus kab mob HIV rau tib neeg kev tiv thaiv kab mob, vim nws tsis tau qhia txog keeb kwm, tsos mob, lossis kev kuaj mob txawv txav qhia tias muaj kab mob HIV. Nrog rau kev zam ntawm kev siv NSAID, nws tsis muaj lwm yam qhia txog qhov tshwm sim rau ob sabmob hnyavpyelonephritis mob. Interestingly, nws tau noj tizanidine hydrochloride, cov nqaij ntshiv, uas cuam tshuam rau lub zais zis skeletal leeg ua haujlwm, thiab uas tuaj yeem siv los kho lub zais zis tsis ua haujlwm hauv cov neeg mob uas muaj ntau yam sclerosis spasticity (26). Tsis muaj cov ntaub ntawv qhia txog tizanidine-koom nrogmob hnyavpyelonephritis mob; Txawm li cas los xij, tus neeg mob tam sim no yuav tsum tau ua tib zoo saib xyuas cov tsos mob, nrog rau lub zais zis ntau dhau.

Qee qhov saum toj no nta ntawmmob hnyavpyelonephritis mobinduced hnyavmob hnyavraumraug mob rauzoo li zoo li lwm yam ua raumob hnyavraumraug mob, suav nrog AIN, mob tubular necrosis (ATN), thiab sai sai glomerulonephritis (RPGN). Tag nrho cov xwm txheej no tuaj yeem ua raumob hnyavraumraug mobnrog ob tograumloj. Cov kev kho mob uas tshwm sim ntawm AIN tsis yog tshwj xeeb, suav nrog asthenia, anorexia, xeev siab, thiab ntuav. Laboratory cov ntaub ntawv qhiamob hnyavraumraug mobnrog los yog tsis muaj oliguria, microscopic hematuria, non-nephrotic proteinuria, thiab pyuria. Tsis zoo limob hnyavpyelonephritis mob, AIN tuaj yeem cuam tshuam nrog WBC casts thiab tsis pigmented granular casts hauv cov zis. Cov neeg mob nrog ATN kuj muaj cov tsos mob tsis tshwj xeeb. Tsis zoo limob hnyavpyelonephritis mob, pigmented "muddy xim av" granular casts los yog tubular epithelial cell casts, feem ntau muaj microscopic hematuria thiab me me proteinuria, yog pom. Txawm li cas los xij, casts tuaj yeem tsis tuaj (29). Cov neeg mob uas muaj RPGN vim crescentic glomerulonephritis qhia qhov mob hauv plab, uas tsis tshua muaj tshwm sim. Leukocytosis, anemia, thiab inflammatory marker theem feem ntau pom muaj. Cov tshuaj urinalysis qhia cov proteinuria me me, microscopic hematuria, thiab RBC thiab WBC cam, tsis zoo limob hnyavpyelonephritis mob. Pyuria kuj yog ib qho kev tshawb pom cov zis. Tsis tshua muaj, kev tshawb pom cov zis yuav tsawg, thiab qhov tsis muaj cov zis tso zis tsis suav nrog kev kuaj mob RPGN. Tus nqi nce mus rauraumkev ua tsis tiav yog qhov sib txawv, txij li teev mus rau lub hlis.

Thaum cov yam ntxwv ntawm AIN, ATN, thiab RPGN raug muab piv, pyuria tsis muaj cov kab mob pathological tuaj yeem yog qhov cim ntawmmob hnyavpyelonephritis mobinduced hnyavmob hnyavraumraug mob. Kev cais tawm pyuria yog qhov txawv txav txij li cov tshuaj tiv thaiv inflammatory hauv covraumlos yog kev sib sau ua ke kuj tseem cuam tshuam nrog hematuria. Lub xub ntiag ntawm WBCs nrog cov kab mob yog qhov qhia txogpyelonephritis mob. Txawm li cas los xij, yog tias cov neeg mob tau siv tshuaj, xws li NSAIDs, uas tuaj yeem ua rau AIN lossis ATN, nws nyuaj rau kev ntxub ntxaug lwm yam tshuaj.mob hnyavraumraug moblos ntawmmob pyelonephritis tshwm sim mob hnyavraumraug mob, zoo li peb cov ntaub ntawv. Ntxiv mus, hauvmob hnyavraumraug mobCov neeg mob uas muaj cov tsos mob ntawm kev cai lij choj thiab cov txiaj ntsig tsis tshwj xeeb, qhov ua tau ntawm RPGN tsis tuaj yeem raug cais tawm. Kev kuaj pom tseeb ntawmmob hnyavpyelonephritis mobinducedmob hnyavraumraug mobyuav tsum tau kuaj lub raum biopsy. Txawm li cas los xij, hauv qee cov neeg mob, araumbiopsy tsis tuaj yeem ua tau yooj yim thiab ua tau sai vim muaj mob. Yogmob hnyavraumraug mobCov neeg mob muaj cov kab mob sib kis, pyuria tsis muaj casts, thiab ob sabraumo, tom qab pib kho cov tshuaj tua kab mob thiab tshem tawm cov tshuaj xav tau, araumKev kuaj ntshav biopsy tuaj yeem ncua mus txog thaum lwm cov ntaub ntawv, suav nrog cov txiaj ntsig ntawm PRGN cov ntaub ntawv kuaj mob ntsig txog thiab qhov ua tau zoo ntawm kev kho tshuaj tua kab mob nyob rau lwm ob peb hnub, tuaj yeem tau txais.

Hauv kev xaus, cov yam ntxwv tseem ceeb ntawmmob hnyavpyelonephritis mobinduced hnyavmob hnyavraumraug mobsuav nrog ob tograumo nrog pyuria yam tsis muaj casts. Oligoanuria feem ntau cuam tshuam nrogmob hnyavpyelonephritis mobinduced mob hnyavraumraug mob, thiab NSAIDs tuaj yeem yog qhov muaj feem pheej hmoo. Kev kho mob sai sai raws li kev kho mob cov yam ntxwv ntawmmob hnyavpyelonephritis mobinducedmob hnyavraumraug mobyog qhov tseem ceeb los txhim khoraumqhov tshwm sim.

Cistanche tuaj yeem txhim khoraumua haujlwm thiab zamMob hnyavLub raumKev raug mobinduced los ntawmMob hnyavPyelonephritis.

Cov ntaub ntawv

Lub hauv paus yog los ntawm Pyuria tsis muaj Casts thiab BilateralLub raumKev loj hlob yog tej zaum Hallmarks ntawm hnyavMob hnyavLub raumKev raug mobInduced los ntawmMob hnyavPyelonephritis: Ib Daim Ntawv Qhia Txog Cov Ntaub Ntawv thiab Kev Tshawb Xyuas Cov Ntawv Sau los ntawm Kohei Odajima thiab lwm yam.