García Donaire J A, Manzanera M I, Valentín M O, Espejo B, Gutiérrez Martínez E, Praga M
Servicio de Nefrología, Hospital 12 de Octubre, Madrid.
Nefrologia. 2004;24(2):179-82.
Although nondiabetic nephropathies are common among type 2 diabetic patients, very few cases of minimal change nephrotic syndrome have been reported in diabetic patients. We describe a type 2 diabetic patient that rapidly developed a nephrotic syndrome accompanied by a mild worsening of renal function. Proteinuria was negative one year before and no signs of diabetic retinopathy were found. Renal biopsy established the diagnosis of minimal change disease. Steroid treatment induced a complete remission of nephrotic syndrome and recovery of normal renal function. However, massive proteinuria relapsed two years later. A second cycle of steroids was followed by a disappearance of proteinuria, but a third bout of nephrotic syndrome was observed 6 months later. An 8-weeks cycle of steroids plus chlorambucil induced a complete and persistent remission. Throughout a five-year follow up, no relapse of the nephrotic syndrome was observed and microalbuminuria is negative.
虽然非糖尿病性肾病在2型糖尿病患者中很常见，但糖尿病患者中报道的微小病变肾病综合征病例却很少。我们描述了一名2型糖尿病患者，该患者迅速发展为肾病综合征，并伴有肾功能轻度恶化。一年前蛋白尿为阴性，且未发现糖尿病视网膜病变迹象。肾活检确诊为微小病变病。类固醇治疗使肾病综合征完全缓解，肾功能恢复正常。然而，两年后大量蛋白尿复发。第二轮类固醇治疗后蛋白尿消失，但6个月后又观察到第三次肾病综合征发作。8周的类固醇加苯丁酸氮芥治疗诱导了完全且持久的缓解。在整个五年的随访中，未观察到肾病综合征复发，微量白蛋白尿为阴性。
