Τίτλος:
“Diabetic nephropathy” in a non-diabetic patient
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Kimmelstiel and Wilson originally described nodular glomerulosclerosis as the pathognomonic lesion of diabetic nephropathy. Nevertheless, nodular glomerulosclerosis pattern can rarely occur in non-diabetic patients. In such cases, the differential diagnosis includes membranoproliferative glomerulonephritis, light or heavy chain deposition disease, amyloidosis, fibrillary and immunotactoid glomerulonephritis and chronic hypoxic or ischemic conditions. In cases that the above entities cannot be proven, the term idiopathic nodular glomerulosclerosis is given. Here, we report a case of a male patient with renal failure stage IV and non-nephrotic range proteinuria. He had a history of heavy smoking and hypertension. The kidney biopsy revealed diabetic-like lesions. However, there was no evidence of glucose impairment despite the thorough work-up at the biopsy time and thereafter. The laboratory data and the electron microscopy of the specimen could not prove any other cause of nodular glomerulosclerosis, and the final diagnosis was idiopathic nodular glomerulosclerosis. Moreover, we focus on the pathological differential diagnosis and work-up. © 2016 Elsevier GmbH
Συγγραφείς:
Balafa, O.
Liapis, G.
Pavlakou, P.
Baltatzis, G.
Kalaitzidis, R.
Elisaf, M.
Περιοδικό:
PATHOLOGY RESEARCH AND PRACTICE
Λέξεις-κλειδιά:
carvedilol; complement component C1q; complement component C3; immunoglobulin A; immunoglobulin G; immunoglobulin kappa chain; immunoglobulin lambda chain; nifedipine; sotalol, abnormal laboratory result; adult; arteriolohyalinosis; Article; blood pressure; body mass; bone marrow biopsy; case report; diabetic nephropathy; diabetic patient; differential diagnosis; disease severity; echocardiography; fibrillar glomerulonephritis; follow up; glomerulonephritis; heart left ventricle hypertrophy; histopathology; human; human tissue; hypertension; idiopathic nodular glomerulosclerosis; immune complex nephritis; immunofluorescence; immunological procedures; kidney amyloidosis; kidney biopsy; kidney failure; kidney fibrosis; kidney function; kidney size; male; medical history; membranoproliferative glomerulonephritis; microscopy; middle aged; nephrosclerosis; non diabetic patient; normochromic normocytic anemia; proteinuria; renography; smoking; urine sediment; Diabetic Nephropathies; kidney; pathology; Renal Insufficiency, Diabetic Nephropathies; Diagnosis, Differential; Glomerulonephritis; Humans; Kidney; Male; Middle Aged; Renal Insufficiency
DOI:
10.1016/j.prp.2016.09.018
