Kitazawa M, Tomosugi N, Ishii T, Hotta F, Nishizawa M, Itou T, Nakano S, Kigoshi T, Ishikawa I, Uchida K
Department of Internal Medicine, Kanazawa Medical University, Uchinada, Ishikawa.
Intern Med. 1997 Dec;36(12):906-11. doi: 10.2169/internalmedicine.36.906.
We describe a rare case of a rapidly progressive glomerulonephritis (RPGN) superimposed on diabetic nephropathy. A 68-year-old woman with non-insulin-dependent diabetes mellitus (NIDDM) complicated with diabetic triopathy demonstrated a rapid deterioration of renal function. Her urinary sediment contained many red blood cell (RBC) cells and casts, suggesting an additional renal disease accompanying diabetic nephropathy. Renal biopsy revealed crescent formation in many glomeruli characteristic of the pauci-immune type of RPGN. Steroid pulse therapy transiently halted the deterioration in renal function, but the patient died of pneumonia complicated with methicillin-resistant staphylococcus aureus (MRSA) infection. The unusual findings in diabetic nephropathy indicated the coexistence of primary glomerulonephritis and diabetic glomerulosclerosis in this case.
我们描述了一例罕见的叠加于糖尿病肾病之上的快速进展性肾小球肾炎（RPGN）病例。一名68岁的非胰岛素依赖型糖尿病（NIDDM）合并糖尿病三联症的女性，肾功能迅速恶化。她的尿沉渣中有许多红细胞（RBC）和管型，提示糖尿病肾病合并另一种肾脏疾病。肾活检显示许多肾小球有新月体形成，这是寡免疫型RPGN的特征。类固醇冲击疗法暂时阻止了肾功能的恶化，但患者死于合并耐甲氧西林金黄色葡萄球菌（MRSA）感染的肺炎。该糖尿病肾病中的异常发现表明，此病例存在原发性肾小球肾炎和糖尿病肾小球硬化症并存的情况。
