title: [Woman with type 1 diabetes mellitus and rapidly progressive edema].
abstract: METHODS
  A 47-year-old woman with type 1 diabetes mellitus was presented for evaluation of progressive oedema, fatigue and weight gain. Her medical history was significant for arterial hypertension and autoimmune thyroiditis requiring substitution therapy with levothyroxine. Physical examination revealed bilateral malleolar and crural oedema, swelling of the eyelids and two-sided pleural effusions. DIAGNOSTIC, TREATMENT AND COURSE: The blood level of albumin was very low, urine analysis showed proteinuria of > 8 g/day. The kidney biopsy revealed only slight changes. This led in combination with the blood and urine results to the diagnosis of minimal change glomerulopathy. After initiation of high dose prednisolone the patient achieved near total remission within four weeks. Prednisolone therapy was tapered over several months.
  
  
  CONCLUSIONS
  In patients with diabetes mellitus and suddenly occurring nephrotic syndrome other diseases than diabetic nephropathy have to be considered. In most cases a kidney biopsy is mandatory.
authors.affiliation: Medizinische Klinik I, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Bochum. marianne.ehren@bergmannsheil.de
authors.forename: M
authors.initials: M
authors.lastname: Ehren
authors.forename: J W
authors.initials: JW
authors.lastname: Dietrich
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001706:Biopsy; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D003928:Diabetic Nephropathies / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D003937:Diagnosis, Differential; D018450:Disease Progression; D004487:Edema / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D008854:Microscopy, Electron; D008875:Middle Aged; D009402:Nephrosis, Lipoid / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D009404:Nephrotic Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use; D015430:Weight Gain
chemical_list: D000893:Anti-Inflammatory Agents; D011239:Prednisolone