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Diagnosis: Diabetic Nephropathy and Membranous Glomerulonephritis
In a disease as prevalent and with such a long evolution as diabetes mellitus, it is not uncommon for a patient with diabetic nephropathy to have another glomerulopathy superimposed, the ones that most frequently overlap, in the literature, are membranous GN, infection-associated GN, and IgA nephropathy, however, the list is very long. The diagnosis of superimposed glomerulopathy can be somewhat difficult in some cases, however, with a good study of light microscopy and immunofluorescence we can suspect or confirm this second glomerular alteration in the vast majority of cases.
See the chapter: Diabetic Nephopathy of our Tutorial
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References
- Shang S, Cui S, Wang W, Wang C, Li P, Li W, Li Q. Retrospective analysis of leflunomide and low-dose methylprednisolone for the treatment of diabetic nephropathy combined with membranous nephropathy. Front Endocrinol (Lausanne). 2022;13:941215. [PubMed link]
- Prakash J, Patel PS, Iqbal M, Sharma SS, Singh S, Agrawal NK, Singh U. Histological Spectrum of Clinical Kidney Disease in Type 2 Diabetes Mellitus Patients with special Reference to nonalbuminuric Diabetic Nephropathy: A Kidney Biopsy-based Study. J Assoc Physicians India. 2022;70(8):11-12. [PubMed link]
- Lyngdoh BS, Baishya P, Mishra J, Marbaniang E, Dey B. IgA nephropathy superimposed on diabetic nephropathy: A case report with review of literature in eight Indian studies. J Family Med Prim Care. 2021;10(6):2419-2422. [PubMed link]
- Kaya B, Paydas S, Kuzu T, Basak Tanburoglu D, Balal M, Eren Erdogan K, Gonlusen G. Primary glomerulonephritis in diabetic patients. Int J Clin Pract. 2021;75(3):e13713. [PubMed link]
- Cossey LN, Messias N, Messias E, Walker PD, Silva FG. Defining the spectrum of immunoglobulin A-dominant/codominant glomerular deposition in diabetic nephropathy. Hum Pathol. 2014;45(11):2294-301. [PubMed link]