'Diabetic nephropathy' in a non-diabetic patient
| Autor: | Georgios Baltatzis, Olga Balafa, Rigas Kalaitzidis, Moses Elisaf, Paraskevi Pavlakou, Georgios Liapis |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
Pathology medicine.medical_specialty Kidney Pathology and Forensic Medicine Diabetic nephropathy Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Glomerulonephritis Pathognomonic 0502 economics and business Membranoproliferative glomerulonephritis Biopsy medicine Humans Diabetic Nephropathies Renal Insufficiency Pathological Proteinuria medicine.diagnostic_test business.industry Amyloidosis 05 social sciences Cell Biology Middle Aged medicine.disease 030220 oncology & carcinogenesis 050211 marketing Differential diagnosis medicine.symptom business |
| Zdroj: | Pathology, research and practice. 212(12) |
| ISSN: | 1618-0631 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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