Kitahara Masashi, Kurata Kenji
Department of Pediatrics, NHO Matsumoto Medical Center, Matsumoto, Japan.
Biomed Hub. 2025 Mar 24;10(1):81-85. doi: 10.1159/000545216. eCollection 2025 Jan-Dec.
In rare cases, idiopathic nephrotic syndrome (NS) and type 1 diabetes coexist, with diabetes typically preceding NS or presenting almost simultaneously with an acute onset requiring immediate insulin therapy.
We report a unique case of a 5.1-year-old male who developed idiopathic NS and experienced glycosuria during steroid treatments for relapses, initially attributed to steroid-induced hyperglycemia. At age 10.2, he developed persistent glycosuria without steroid administration, and an oral glucose tolerance test confirmed diabetes. Despite positive anti-insulinoma-associated protein-2 antibodies, the patient maintained non-insulin-dependent glycemic control until, 13 months later, rapid-onset hyperglycemia necessitated insulin therapy, leading to a diagnosis of slowly progressive type 1 diabetes (SPT1D).
This case represents the first reported instance of steroid-sensitive relapsing NS followed by SPT1D in childhood.
在罕见情况下，特发性肾病综合征（NS）与1型糖尿病共存，糖尿病通常先于NS出现，或几乎与急性发作同时出现，需要立即进行胰岛素治疗。
我们报告了一例独特的病例，一名5.1岁男性患特发性NS，在复发的类固醇治疗期间出现糖尿，最初归因于类固醇诱导的高血糖。10.2岁时，他在未使用类固醇的情况下出现持续性糖尿，口服葡萄糖耐量试验确诊为糖尿病。尽管抗胰岛素瘤相关蛋白-2抗体呈阳性，但该患者在13个月后快速发作的高血糖症需要胰岛素治疗之前一直维持非胰岛素依赖型血糖控制，最终诊断为缓慢进展型1型糖尿病（SPT1D）。
该病例是儿童期类固醇敏感复发性NS后发生SPT1D的首例报道。
