An elderly patient with diabetic nephropathy complicated by ANCA-associated nephritis.
A 67-year-old man, on oral therapy for type 2 diabetes mellitus since 1990, had sustained proteinuria since 2005. When hematuria was first discovered in 2008, renal dysfunction [creatinine (Cr), 1.2 mg/dL], inflammation [C-reactive protein (CRP), 12 mg/dL] and high myeloperoxidase anti-neutrophil cytoplasmic antibodies (MPO-ANCA) levels [546 ELISA units (EU)] were observed. Renal biopsy showed the diagnosis of ANCA-associated nephritis combined with diabetic nephropathy. For this patient, there was pathological proof of the combination of diabetic nephropathy and ANCA-associated vasculitis.
The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan. tnishino@nagasaki-u.ac.jp
Tomoya
T
Nishino
Kana
K
Minami
Tadashi
T
Uramatsu
Yoko
Y
Obata
Hideyuki
H
Arai
Noriho
N
Sakamoto
Takashi
T
Taguchi
Shigeru
S
Kohno
D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000378:metabolism*; D003928:Diabetic Nephropathies / Q000150:complications* / Q000473:pathology; D005921:Glomerulonephritis / Q000150:complications* / Q000276:immunology* / Q000473:pathology; D006801:Humans; D008297:Male
D019268:Antibodies, Antineutrophil Cytoplasmic