Steroid-Responsive Relapsing Nephrotic Syndrome Associated with Early Diabetic Glomerulopathy in a Child

Peces, R; Riera, J.R.; Larrea, Carlos López; Álvarez, Julio C.

doi:10.1159/000184310

Cited by 16 publications

(11 citation statements)

References 8 publications

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“…The coexistence of type 1 diabetes and SSNS in children was reported previously [6][7][8][9][10][11][12]. We hereby present four children with SSNS and type 1 diabetes.…”

Section: Introductionsupporting

confidence: 65%

“…Both diseases are known to have an immunological basis, but the aetiology for the probable causal or synergistic relationship between the two is unknown. Peces et al [11] reported a child with NS and type 1 diabetes who had HLA-DR4 and DR-7, which are known to be associated with type 1 diabetes and MCD, respectively. They speculated that these HLA loci might carry a genetic predisposition for the development of both diseases.…”

Section: Discussionmentioning

confidence: 99%

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Management of steroid-sensitive nephrotic syndrome in children with type 1 diabetes

Goldman

Hébert

Geary

2002

Pediatric Nephrology

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Four children with steroid-sensitive nephrotic syndrome (SSNS) coexisting with type 1 diabetes are presented. This number is higher than expected according to the estimated prevalence rates for each disease separately. In three, diabetes preceded nephrotic syndrome (NS), and in one it developed almost simultaneously. None of the patients had hypertension or retinopathy. Two had a renal biopsy: in one it was compatible with minimal change histology (MCH), and the other had MCH and early diabetic nephropathy changes. In addition to the two presented here, in 11 of 12 previously reported cases with biopsy proven SSNS coexisting with type 1 diabetes, the biopsy showed MCH. In none was treatment influenced by biopsy results. However, our experience suggests that daily steroid taper allows easier glycaemic control than alternate day steroids. We conclude that the indications for a renal biopsy in nephrotic children with and without insulin-dependent diabetes mellitus (IDDM) should be similar.

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“…The coexistence of type 1 diabetes and SSNS in children was reported previously [6][7][8][9][10][11][12]. We hereby present four children with SSNS and type 1 diabetes.…”

Section: Introductionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Management of steroid-sensitive nephrotic syndrome in children with type 1 diabetes

Goldman

Hébert

Geary

2002

Pediatric Nephrology

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“…Main types of glomerulonephritis reported as complications in diabetic patients included membranous glomerulonephritis [3, 8, 10, 11, 13, 14, 18, 20, 24, 25, 30, 35], minimal-change nephrotic syndrome [2, 5, 25, 26, 35], endocapillary proliferative glomerulonephritis [1, 4, 7, 9, 20, 24, 25, 35], membranoproliferative glomerulonephritis [2, 6, 8], dense deposit disease [12], rapidly progressive glomerulonephritis [12, 20, 30, 35], cryoglobulinemic glomerulonephritis [22, 24], lupus nephritis [15, 18], periarteritis nodosa vasculitis [21], Henoch-Schönlein nephritis [18, 27, 33, 38, 39], and amyloidosis [35]. …”

Section: Discussionmentioning

confidence: 99%

“…However, several reports have shown that glomerulonephritis mediated by immune complexes can complicate diabetic renal disease [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39]. The most common lesion complicating DGS is membranous glomerulonephritis [3, 8, 10, 11, 13, 14, 18, 20, 24, 25, 30, 35] whereas IgA nephropathy [16, 18, 19, 23, 30, 31, 32, 34, 36, 37] is rarely described.…”

Section: Introductionmentioning

confidence: 99%

IgA Nephropathy Complicating Diabetic Glomerulosclerosis

Orfila

Lepert

Modesto

et al. 1998

Nephron

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A retrospective study was done on 66 diabetic patients who had renal biopsies performed during 1979–1994. This review shows 10 patients who presented IgA nephropathy associated with diabetic nephropathy. Six patients had insulin-dependent diabetes mellitus and 4 patients non-insulin-dependent diabetes mellitus. All patients presented with proteinuria and 7 had hematuria. Four patients presented with renal impairment. Histologic evaluation disclosed the presence of thickened glomerular basement membranes and increased mesangial matrix in all cases, associated with nodular sclerosis in 8 cases. By immunofluorescence, diffuse mesangial IgA deposits were observed in all cases. The high incidence of the coexistence of IgA nephropathy and diabetes seems not merely coincidental. Structural and/or functional abnormalities of the glomerular basement membranes might facilitate the development of immune complex glomerular diseases. In patients with diabetes, the appearance of urinary abnormalities and/or deterioration in renal function altered the clinical history of diabetic nephropathy. The disorders are clinically suggestive of the presence of nondiabetic renal disease and raised the possibility of another pathogenetic mechanism.

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“…Nearly half of the patients treated with Glucocorticoids for more than two weeks developed a deranged glucose metabolism 4 . Some case reports had published associated with Insulin dependent Diabetes Mellitus, Diabetic Ketoacidosis with nephrotic syndrome who are treated with prednisolone [5][6][7][8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

Relationship between HbA1c and Steroid in Initial Attack of Idiopathic Nephrotic Syndrome in Children

Naher

Sultana

Matin

2018

J. Natl Inst. Neurosci Bangladesh

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Background: Blood sugar may be raised as a systemic effect of steroid. Haemoglobin A1c (HbA1c) estimation provides an accurate index of mean concentration of blood glucose during preceding two to three months. Objective: The purpose of the present study was to observe the relationship between oral prednisolone and HbA1c levels in children with 1st attack Nephrotic syndrome. Methods: This case-control study was conducted in the Outpatient department of Apollo Hospitals, Dhaka, Bangladesh from January 2012 to July 2013 for a period of nineteenth (19) months. The nephrotic children with first attack who completed 12 weeks steroid therapy were enrolled as study group. Age and sex matched thirty children with other illness without family history of diabetes regarded as control. HbA1c level was estimated in Nephrotic patient just at the end of their 12 weeks of prednisolone therapy. Results: The mean age of study and control group was 4.56±1.54 and 4.90±1.06 years respectively. Male and female ratios were 1.0:0.76 and 1.0:0.88 in case and control group respectively. Age and sex difference between the groups were not significant. The mean HbA1c value was 5.00±0.28 in case and 4.43±0.35 in control group (p<0.0001). The calculated mean blood sugar level was 99.75±9.80 mg/dl and 80.30±12.48 mg/dl in case and control group respectively (p<0.0001). Conclusion: Nephrotic child getting steroid have significantly higher level of HbA1c then their healthy counterpart though the level is not at diabetic level. [Journal of National Institute of Neurosciences Bangladesh, 2017;3(1): 7-9]

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Steroid-Responsive Relapsing Nephrotic Syndrome Associated with Early Diabetic Glomerulopathy in a Child

Cited by 16 publications

References 8 publications

Management of steroid-sensitive nephrotic syndrome in children with type 1 diabetes

Management of steroid-sensitive nephrotic syndrome in children with type 1 diabetes

IgA Nephropathy Complicating Diabetic Glomerulosclerosis

Relationship between HbA1c and Steroid in Initial Attack of Idiopathic Nephrotic Syndrome in Children

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