A Case of Anti-Glomerular Basement Membrane Glomerulonephritis Complicated by Type 1 Diabetes Mellitus, Mimicking Urinary Tract Infection.
BACKGROUND Type 1 diabetes mellitus (DM) tends to complicate other autoimmune diseases. When considering renal dysfunction in patients with DM, diabetic nephropathy is a likely diagnosis. By contrast, anti-glomerular basement membrane (GBM) glomerulonephritis, an autoimmune disease, is one cause of rapidly progressive glomerulonephritis. CASE REPORT We report the case of a 44-year-old woman diagnosed with anti-glomerular basement membrane (GBM) glomerulonephritis. The diagnosis was made on the basis of serological test results and pathological findings of a renal biopsy. Five years before admission, she was diagnosed with type 1 DM. At admission, she presented with a fever, chills, nausea, low back pain, and malaise, which were followed by progressive renal dysfunction. The initial presentation mimicked a urinary tract infection, which delayed the correct diagnosis. CONCLUSIONS Our patient's course strongly suggests that rapidly progressive glomerulonephritis should be considered as an early differential diagnosis in cases of progressive renal dysfunction, especially when accompanied by fever, regardless of the underlying disease.
Department of Internal Medicine, Asahi General Hospital, Chiba, Japan.
Yoshihiro
Y
Aoki
Department of Internal Medicine, Asahi General Hospital, Chiba, Japan.
Izumi
I
Tanimoto
Department of Nephrology, Asahi General Hospital, Chiba, Japan.
Yoshihiro
Y
Miyauchi
Department of Pathology, Asahi General Hospital, Chiba, Japan.
Yoshio
Y
Suzuki
Department of Pathology, Asahi General Hospital, Chiba, Japan.
Toshiaki
T
Shiojiri
D000328:Adult; D019867:Anti-Glomerular Basement Membrane Disease / Q000175:diagnosis*; D057210:Delayed Diagnosis; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003937:Diagnosis, Differential; D005260:Female; D005921:Glomerulonephritis / Q000175:diagnosis*; D006801:Humans; D014552:Urinary Tract Infections / Q000175:diagnosis