Nishino Tomoya, Minami Kana, Uramatsu Tadashi, Obata Yoko, Arai Hideyuki, Sakamoto Noriho, Taguchi Takashi, Kohno Shigeru
The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
Intern Med. 2012;51(10):1227-32. doi: 10.2169/internalmedicine.51.6775. Epub 2012 May 15.
A 67-year-old man, on oral therapy for type 2 diabetes mellitus since 1990, had sustained proteinuria since 2005. When hematuria was first discovered in 2008, renal dysfunction [creatinine (Cr), 1.2 mg/dL], inflammation [C-reactive protein (CRP), 12 mg/dL] and high myeloperoxidase anti-neutrophil cytoplasmic antibodies (MPO-ANCA) levels [546 ELISA units (EU)] were observed. Renal biopsy showed the diagnosis of ANCA-associated nephritis combined with diabetic nephropathy. For this patient, there was pathological proof of the combination of diabetic nephropathy and ANCA-associated vasculitis.
一名67岁男性，自1990年起接受2型糖尿病口服治疗，自2005年起持续存在蛋白尿。2008年首次发现血尿时，观察到肾功能不全[肌酐（Cr），1.2mg/dL]、炎症反应[C反应蛋白（CRP），12mg/dL]以及高髓过氧化物酶抗中性粒细胞胞浆抗体（MPO-ANCA）水平[546酶联免疫吸附测定单位（EU）]。肾活检显示诊断为ANCA相关性肾炎合并糖尿病肾病。对于该患者，有糖尿病肾病与ANCA相关性血管炎合并存在的病理证据。
