An Elderly Patient with Diabetic Nephropathy Complicated by ANCA-associated Nephritis

Tomoya Nishino; Kana Minami; Tadashi Uramatsu; Yoko Obata; Hideyuki Arai; Noriho Sakamoto; Takashi Taguchi; Shigeru Kohno

doi:10.2169/internalmedicine.51.6775

CASE REPORTS

An Elderly Patient with Diabetic Nephropathy Complicated by ANCA-associated Nephritis

Tomoya Nishino, Kana Minami, Tadashi Uramatsu, Yoko Obata, Hideyuki Arai, Noriho Sakamoto, Takashi Taguchi, Shigeru Kohno

Author information

Tomoya Nishino
The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan
Kana Minami
The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan
Tadashi Uramatsu
The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan
Division of Blood Purification, Nagasaki University Hospital, Japan
Yoko Obata
The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan
Career Development Center for Medical Doctor, Nagasaki University Hospital, Japan
Hideyuki Arai
The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan
Noriho Sakamoto
The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan
Takashi Taguchi
Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Japan
Shigeru Kohno
The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan

Keywords: ANCA-associated nephritis, type 2 diabetes mellitus, diabetic nephropathy

JOURNAL OPEN ACCESS

2012 Volume 51 Issue 10 Pages 1227-1232

DOI https://doi.org/10.2169/internalmedicine.51.6775

Details

Abstract

A 67-year-old man, on oral therapy for type 2 diabetes mellitus since 1990, had sustained proteinuria since 2005. When hematuria was first discovered in 2008, renal dysfunction [creatinine (Cr), 1.2 mg/dL], inflammation [C-reactive protein (CRP), 12 mg/dL] and high myeloperoxidase anti-neutrophil cytoplasmic antibodies (MPO-ANCA) levels [546 ELISA units (EU)] were observed. Renal biopsy showed the diagnosis of ANCA-associated nephritis combined with diabetic nephropathy. For this patient, there was pathological proof of the combination of diabetic nephropathy and ANCA-associated vasculitis.

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