A Case of Nodular Diabetic Glomerulosclersis and Proliferative Retinopathy without Diabetes Mellitus.
- Author:
Seog Jae KIM
;
Jun Chul KIM
;
Sun Hee PARK
;
Chan Duk KIM
;
Mi Young BAEK
;
Jun Hong KIM
;
Sung Ho KIM
;
Yong Lim KIM
;
Dong Kyu CHO
- Publication Type:Case Report
- Keywords:
Nodular glomerulosclerosis;
Proliferative diabetic retinopathy;
Diabetic microangiopathy;
Proteinuria;
Hypertension
- MeSH:
Adult;
Biopsy;
Diabetes Mellitus*;
Diabetic Angiopathies;
Diabetic Nephropathies;
Diabetic Retinopathy;
Fluorescein Angiography;
Glucose;
Glucose Tolerance Test;
Humans;
Hypertension;
Male;
Proteinuria
- From:Korean Journal of Nephrology
1998;17(6):994-998
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Nodular glomerulosclerosis was first described by Kimmelstiel and Wilson in 1936. Diabetic retinopathy and nephropath y are manifestation of the microangiopathy associated with diabetes. The severity of diabetic nephropathy and the occurrence of retinopathy correlate with the duration of clinical diabetes. However, there have been few reports of patients presents presenting with the classic lesions of diabetic microangiopathy in the absence of a known history of diabetes. These reports raise questions regarding the relationship and significance of carbohydrate intolerance to these pathologic abnormalities. A 34-year-old male patient clinically characterized by massive proteinuria and hypertension without evidence of systemic disease is reported. Renal biopsy showed the nodular glomerulosclerosis (Kimmelstiel-Wilson lesion) characteristic of diabetes. Direct opthalmoscopy and fluorescein angiography demonstrated a picture of advanced proliferative diabetic retinopathy. The patient had no history of diabetes mellitus and upon testing had normal glucose values in response to an oral glucose tolerance test. It is concluded that the nodular glomerulosclerosis lesions and proliferative retinopathy, thought to be specific for diabetes mellitus, may present in the absence of either overt clinical diabetes or impaired glucose tolerance.
