Peces R, Riera J R, López Larrea C, Alvarez J
Nephron. 1987;46(1):78-82. doi: 10.1159/000184310.
A child developed steroid-responsive nephrotic syndrome at the age of 3 years. 6 years later, he developed insulin-dependent diabetes mellitus. At this time renal biopsy disclosed minimal-change disease. After multiple relapses requiring cyclophosphamide or repeated courses of steroid therapy, a second renal biopsy, 5 years after the first, revealed early diabetic changes with associated exudative lesions. The nephrotic syndrome remains responsive to steroids and cyclophosphamide, and the patient maintains an increased glomerular filtration rate and normal blood pressure 3.5 years afterwards. His HLA typing showed DR4 and DR7. Since DR4 and DR7 are associated with diabetes and minimal-change disease, respectively, we speculate that he could carry the genetic predisposition for the development of both diseases.
一名儿童在3岁时患上了类固醇反应性肾病综合征。6年后，他又患上了胰岛素依赖型糖尿病。此时肾脏活检显示为微小病变病。在多次复发后需要使用环磷酰胺或反复进行类固醇治疗，首次活检5年后进行的第二次肾脏活检显示出早期糖尿病变化及相关渗出性病变。肾病综合征对类固醇和环磷酰胺仍有反应，3.5年后该患者维持着升高的肾小球滤过率和正常血压。他的HLA分型显示为DR4和DR7。由于DR4和DR7分别与糖尿病和微小病变病相关，我们推测他可能携带这两种疾病发生的遗传易感性。
