Kari Jameela A, El-Desoky Sherif M, Mokhtar Ghadeer, Jalalah Sawsan M
Pediatrics Department, King Abdulaziz University, Jeddah, Saudi Arabia.
BMJ Case Rep. 2010 Nov 29;2010:bcr0420102916. doi: 10.1136/bcr.04.2010.2916.
The cases are reported of two young children who developed insulin-dependent diabetes mellitus (IDDM) within 2 weeks of receiving a diagnosis of nephrotic syndrome. Neither patient responded to 8 weeks of daily prednisolone. The first patient presented at 2 years and 9 months of age. Her renal biopsy showed mesangial proliferation. The second child presented with steroid resistant nephrotic syndrome at 18 months of age and developed IDDM 2 weeks later. He achieved partial remission with cyclosporine therapy. His initial renal biopsy at 3 years of age showed minimal change disease and follow-up renal biopsy at 5 years of age showed early diabetic glomerulosclerosis. Tests for NPHS2 and WT1 genetic mutations were negative in both patients. To our knowledge this is the first report of steroid resistant nephrotic syndrome with almost simultaneous onset of IDDM in young children.
报告了两例幼儿病例，他们在被诊断为肾病综合征后2周内发展为胰岛素依赖型糖尿病（IDDM）。两名患者接受每日泼尼松龙治疗8周均无反应。第一名患者发病时为2岁9个月。她的肾活检显示系膜增生。第二名儿童在18个月大时出现激素抵抗性肾病综合征，并在2周后发展为IDDM。他接受环孢素治疗后实现部分缓解。他3岁时的初次肾活检显示为微小病变病，5岁时的随访肾活检显示早期糖尿病肾小球硬化。两名患者的NPHS2和WT1基因突变检测均为阴性。据我们所知，这是首次报道幼儿中激素抵抗性肾病综合征几乎同时并发IDDM的病例。
