ホシノ　ジユンイチ   HOSHINO Junichi   星野　純一    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Characteristic Renal Histology of a 81-Year-Old Patient with a 30-Year History of Diabetes Mellitus: A Case Report.
掲載誌名	正式名：CEN case reports 略　 称：CEN Case Rep ISSNコード：21924449/21924449
巻・号・頁	9(4),pp.338-343
著者・共著者	Shima Natsuki, Sawa Naoki, Yamanouchi Masayuki, Mizuno Hiroki, Kawada Masahiro, Sekine Akinari, Hiramatsu Rikako, Hayami Noriko, Hasegawa Eiko, Suwabe Tatsuya, Hoshino Junichi, Takaichi Kenmei, Ohashi Kenichi, Fujii Takeshi, Ubara Yoshifumi
発行年月	2020/11
概要	A renal histology of an 81-year-old man with a 30-year history of diabetes mellitus (DM), as well as diabetic retinopathy and neuropathy, was examined. The patient's blood pressure was controlled within the normal range (less than 140/75 mmHg) using antihypertensive agents including angiotensin receptor blocker. Edematous management was achieved by a strict salt diet (less than 6 g/per day). However, this patient's glycemic control was poor with HbA1c 8-10%. Serum creatinine was 0.87 mg/dL and estimated globular filtration rate (eGFR) was 64 ml/min/1.73m2. Urinary protein excretion was 1.5 g/day. This patient's renal biopsy showed linear staining for IgG along the GBM by immunofluorescence microscopy, but light microscopy showed almost intact glomeruli, and the GBM was not thickened as revealed by electron microscopy with a width of 288-368 nm (< 430 nm). While arteriolar hyalinosis was severe, and polar vasculosis was observed around the glomerular vascular pole. This case indicates that long-standing hyperglycemia may induce polar vasculosis by the mechanism of angiogenesis, but diabetic glomerulopathy can become minor change, only when hypertension and edematous management could be controlled strictly.
DOI	10.1007/s13730-020-00483-9
PMID	32361867