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一种不寻常的关联:1型糖尿病患者的新月体性肾小球肾炎

An Unusual Association: Collapsing Glomerulonephritis in a Patient With Type 1 Diabetes.

作者信息

Aladashvili Zaza, Beridze Luka, Zaalishvili Elene, Bichinashvili Luka, Shamanadze Anna

机构信息

Faculty of Medicine, Tbilisi State Medical University, Tbilisi, GEO.

Department of Internal Medicine, Petre Shotadze Tbilisi Medical Academy, Tbilisi, GEO.

出版信息

Cureus. 2025 Aug 8;17(8):e89622. doi: 10.7759/cureus.89622. eCollection 2025 Aug.

Abstract

This case report describes a 38-year-old female patient with type 1 diabetes who developed collapsing-type glomerulonephritis (CTGN), a rare but severe kidney injury. The patient presented with nephrotic syndrome symptoms, including edema and hypertension. Laboratory tests showed significant proteinuria with normal serum creatinine and glomerular filtration rate. A renal biopsy confirmed CTGN, marked by podocyte injury and glomerular capillary collapse. Given the patient's type 1 diabetes, the potential link between hyperglycemia, metabolic disturbances, and CTGN pathogenesis was explored. Treatment focused on stringent glycemic control, without immunosuppressive therapy, resulting in reduced proteinuria. This case underscores the importance of recognizing CTGN in diabetic patients and suggests a possible multifactorial component in its development. Further research is needed to clarify the underlying pathophysiology and optimize management strategies.

摘要

本病例报告描述了一名患有1型糖尿病的38岁女性患者,她患上了塌陷型肾小球肾炎(CTGN),这是一种罕见但严重的肾损伤。患者出现了肾病综合征症状,包括水肿和高血压。实验室检查显示有大量蛋白尿,血清肌酐和肾小球滤过率正常。肾活检确诊为CTGN,其特征为足细胞损伤和肾小球毛细血管塌陷。鉴于患者患有1型糖尿病,探讨了高血糖、代谢紊乱与CTGN发病机制之间的潜在联系。治疗重点是严格控制血糖,未进行免疫抑制治疗,蛋白尿有所减少。本病例强调了在糖尿病患者中识别CTGN的重要性,并提示其发病可能存在多因素成分。需要进一步研究以阐明潜在的病理生理学并优化管理策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da0b/12414485/6c8d70af7fa4/cureus-0017-00000089622-i01.jpg

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