Gilboa N, Durante D, McIntosh R M, Guggenheim S
Arch Pathol Lab Med. 1979 Aug;103(9):479-82.
Clinicopathologic studies of four patients with juvenile diabetes mellitus and renal disease demonstrated the pathogenetic variability of nephropathy in diabetic patients. Only in one patient was the clinical nephropathy associated with the typical diabetic glomerulosclerosis. Another patient had steroid responsive nephrotic syndrome superimposed on minimal diabetic glomerulosclerosis. A third patient had steroid resistant nephrotic syndrome associated with mild diabetic glomerulosclerosis and with later appearance of Grave's disease. The fourth patient, in addition to moderate diabetic glomerulosclerosis had prominent tubulointerstitial nephritis, the latter probably being responsible for the rapidly declining renal function. The poor prognosis associated with diabetic nephropathy warrants a careful search for other potentially treatable causes of nephropathy in patients with juvenile diabetes mellitus.
对四名青少年糖尿病合并肾脏疾病患者的临床病理研究表明，糖尿病患者肾病的发病机制具有变异性。仅一名患者的临床肾病与典型的糖尿病肾小球硬化相关。另一名患者在轻度糖尿病肾小球硬化基础上叠加了类固醇反应性肾病综合征。第三名患者患有类固醇抵抗性肾病综合征，伴有轻度糖尿病肾小球硬化，随后出现格雷夫斯病。第四名患者除中度糖尿病肾小球硬化外，还伴有显著的肾小管间质性肾炎，后者可能是导致肾功能迅速下降的原因。糖尿病肾病相关的不良预后促使我们仔细寻找青少年糖尿病患者中其他可能可治疗的肾病病因。
