Rare Diagnosis in a Patient with Diabetes with Nephrotic Proteinuria
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/4064 |
Resumo: | We report a 63-year-old man with well-controlled type 2 diabetes mellitus and hypertension, who presented with new onset nephrotic proteinuria and rapid deterioration in renal function. The atypical clinical presentation prompted us to consider a non-diabetic and non-hypertensive cause and to perform a renal biopsy. A diagnosis of fibrillarglomerulonephritis (FGn) was made based on electronic microscopy. Proteinuria remained in nephrotic range despite treatment with prednisolone, and renal function deteriorated. We suggest that other causes of proteinuria should be considered in patients with diabetes who present with the nephrotic syndrome when there is no other evidence of microvascular disease. We review the spectrum of fibrillar glomerulopathies including FGn, primary and secondary amyloidosis and immunotactoid glomerulonephritis. |
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Rare Diagnosis in a Patient with Diabetes with Nephrotic ProteinuriaHCC NEFMaleHumansMiddle AgedAmyloidosis / diagnosisBiopsy / methodsDiabetes Mellitus, Type 2 / complicationsDiabetes Mellitus, Type 2 / epidemiologyGlomerulonephritis / pathology*Glucocorticoids / therapeutic useNephrotic Syndrome / diagnosis*Nephrotic Syndrome / etiologyNephrotic Syndrome / pathologyPrednisolone / administration & dosagePrednisolone / therapeutic useProteinuria / diagnosis*Proteinuria / etiologyRare DiseasesTreatment OutcomeVascular Access Devices / standardsWe report a 63-year-old man with well-controlled type 2 diabetes mellitus and hypertension, who presented with new onset nephrotic proteinuria and rapid deterioration in renal function. The atypical clinical presentation prompted us to consider a non-diabetic and non-hypertensive cause and to perform a renal biopsy. A diagnosis of fibrillarglomerulonephritis (FGn) was made based on electronic microscopy. Proteinuria remained in nephrotic range despite treatment with prednisolone, and renal function deteriorated. We suggest that other causes of proteinuria should be considered in patients with diabetes who present with the nephrotic syndrome when there is no other evidence of microvascular disease. We review the spectrum of fibrillar glomerulopathies including FGn, primary and secondary amyloidosis and immunotactoid glomerulonephritis.BMJRepositório do Centro Hospitalar Universitário de Lisboa Central, EPEAzevedo, ACotovio, PGóis, MNolasco, F2022-05-03T14:55:40Z20192019-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/4064engBMJ Case Rep. 2019 Jan 10;12(1):bcr-2017-223835.10.1136/bcr-2017-223835.info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:45:09Zoai:repositorio.chlc.min-saude.pt:10400.17/4064Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:21:22.481559Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Rare Diagnosis in a Patient with Diabetes with Nephrotic Proteinuria |
title |
Rare Diagnosis in a Patient with Diabetes with Nephrotic Proteinuria |
spellingShingle |
Rare Diagnosis in a Patient with Diabetes with Nephrotic Proteinuria Azevedo, A HCC NEF Male Humans Middle Aged Amyloidosis / diagnosis Biopsy / methods Diabetes Mellitus, Type 2 / complications Diabetes Mellitus, Type 2 / epidemiology Glomerulonephritis / pathology* Glucocorticoids / therapeutic use Nephrotic Syndrome / diagnosis* Nephrotic Syndrome / etiology Nephrotic Syndrome / pathology Prednisolone / administration & dosage Prednisolone / therapeutic use Proteinuria / diagnosis* Proteinuria / etiology Rare Diseases Treatment Outcome Vascular Access Devices / standards |
title_short |
Rare Diagnosis in a Patient with Diabetes with Nephrotic Proteinuria |
title_full |
Rare Diagnosis in a Patient with Diabetes with Nephrotic Proteinuria |
title_fullStr |
Rare Diagnosis in a Patient with Diabetes with Nephrotic Proteinuria |
title_full_unstemmed |
Rare Diagnosis in a Patient with Diabetes with Nephrotic Proteinuria |
title_sort |
Rare Diagnosis in a Patient with Diabetes with Nephrotic Proteinuria |
author |
Azevedo, A |
author_facet |
Azevedo, A Cotovio, P Góis, M Nolasco, F |
author_role |
author |
author2 |
Cotovio, P Góis, M Nolasco, F |
author2_role |
author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Azevedo, A Cotovio, P Góis, M Nolasco, F |
dc.subject.por.fl_str_mv |
HCC NEF Male Humans Middle Aged Amyloidosis / diagnosis Biopsy / methods Diabetes Mellitus, Type 2 / complications Diabetes Mellitus, Type 2 / epidemiology Glomerulonephritis / pathology* Glucocorticoids / therapeutic use Nephrotic Syndrome / diagnosis* Nephrotic Syndrome / etiology Nephrotic Syndrome / pathology Prednisolone / administration & dosage Prednisolone / therapeutic use Proteinuria / diagnosis* Proteinuria / etiology Rare Diseases Treatment Outcome Vascular Access Devices / standards |
topic |
HCC NEF Male Humans Middle Aged Amyloidosis / diagnosis Biopsy / methods Diabetes Mellitus, Type 2 / complications Diabetes Mellitus, Type 2 / epidemiology Glomerulonephritis / pathology* Glucocorticoids / therapeutic use Nephrotic Syndrome / diagnosis* Nephrotic Syndrome / etiology Nephrotic Syndrome / pathology Prednisolone / administration & dosage Prednisolone / therapeutic use Proteinuria / diagnosis* Proteinuria / etiology Rare Diseases Treatment Outcome Vascular Access Devices / standards |
description |
We report a 63-year-old man with well-controlled type 2 diabetes mellitus and hypertension, who presented with new onset nephrotic proteinuria and rapid deterioration in renal function. The atypical clinical presentation prompted us to consider a non-diabetic and non-hypertensive cause and to perform a renal biopsy. A diagnosis of fibrillarglomerulonephritis (FGn) was made based on electronic microscopy. Proteinuria remained in nephrotic range despite treatment with prednisolone, and renal function deteriorated. We suggest that other causes of proteinuria should be considered in patients with diabetes who present with the nephrotic syndrome when there is no other evidence of microvascular disease. We review the spectrum of fibrillar glomerulopathies including FGn, primary and secondary amyloidosis and immunotactoid glomerulonephritis. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019 2019-01-01T00:00:00Z 2022-05-03T14:55:40Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/4064 |
url |
http://hdl.handle.net/10400.17/4064 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
BMJ Case Rep. 2019 Jan 10;12(1):bcr-2017-223835. 10.1136/bcr-2017-223835. |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
BMJ |
publisher.none.fl_str_mv |
BMJ |
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reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799131309355827200 |