一名老年起病的胰岛素依赖型糖尿病和自身免疫性甲状腺炎患者出现微小病变型肾病综合征和急性肾衰竭。

Minimal-change nephrotic syndrome and acute renal failure in a patient with aged onset insulin-dependent diabetes mellitus and autoimmune thyroiditis.

作者信息

Kagiyama S, Tsuruta H, Tominaga M, Morishita K, Doi Y, Onoyama K

机构信息

Nippon Steel Yawata Memorial Hospital, Kitakyushu, Japan.

出版信息

Am J Nephrol. 1999;19(3):369-72. doi: 10.1159/000013479.

DOI:10.1159/000013479

PMID:10393372

Abstract

A 61-year-old woman with a 2-year history of insulin-dependent diabetes mellitus (IDDM) developed nephrotic syndrome. Renal biopsy showed minimal-change nephrotic syndrome (MCNS), and no evidence of diabetic glomerulosclerosis. Although steroid therapy was initiated, plasma urea and creatinine rose and hemodialysis was required. After 4 weeks, she responded to steroids and her renal function returned to normal. MCNS, which is not associated with diabetic glomerulosclerosis, has rarely been seen in IDDM patients with nephrotic syndrome. Her human leukocyte antigen typing was A24, BW52, BW61, DR2 and DR9. This typing has been reported to be associated with both IDDM and renal disease.

摘要

一名有2年胰岛素依赖型糖尿病（IDDM）病史的61岁女性患了肾病综合征。肾活检显示为微小病变肾病综合征（MCNS），且无糖尿病肾小球硬化的证据。尽管开始了类固醇治疗，但血浆尿素和肌酐仍升高，需要进行血液透析。4周后，她对类固醇产生反应，肾功能恢复正常。MCNS与糖尿病肾小球硬化无关，在患有肾病综合征的IDDM患者中很少见。她的人类白细胞抗原分型为A24、BW52、BW61、DR2和DR9。据报道，这种分型与IDDM和肾脏疾病都有关。