Agras Pinar Isik, Kinik Sibel Tulgar, Cengiz Nurcan, Baskin Esra
Department of Pediatric Nephrology, Baskent University, Ankara, Turkey.
J Pediatr Endocrinol Metab. 2006 Aug;19(8):1045-8. doi: 10.1515/jpem.2006.19.8.1045.
Nephrotic syndrome (NS) in a patient with diabetes mellitus (DM) first suggests the diagnosis of diabetic nephropathy. However, glomerular diseases other than diabetic nephropathy have been reported in patients with DM. We present a child with type 1 DM (DM1) associated with NS. A 3 year-old boy who was diagnosed with DM1 developed proteinuria in nephrotic range at the 10th month of follow-up. He had remission on steroid treatment without any problem in glycemic control as he was given tapered daily doses instead of an alternate day regimen. He relapsed at the 7th month of follow-up, and cyclophosphamide treatment brought about remission. He had HLA A24, DR4 and DR53 antigens in common with previously reported cases of DM-NS association. The immunological basis of these diseases may have a causal effect on the association, but the etiopathogenesis is still unclear.
糖尿病（DM）患者出现肾病综合征（NS）首先提示糖尿病肾病的诊断。然而，DM患者中也有报道存在除糖尿病肾病之外的肾小球疾病。我们报告了一名患有1型糖尿病（DM1）并伴有NS的儿童。一名3岁男孩被诊断为DM1，在随访第10个月时出现肾病范围的蛋白尿。他接受类固醇治疗后缓解，血糖控制没有任何问题，因为给予的是逐渐减量的每日剂量而非隔日疗法。他在随访第7个月时复发，环磷酰胺治疗使其缓解。他与先前报道的DM - NS关联病例有共同的HLA A24、DR4和DR53抗原。这些疾病的免疫基础可能对这种关联有因果影响，但发病机制仍不清楚。
