Minimal change nephrotic syndrome possibly induced by troglitazone administration in a case of non-insulin dependent diabetes mellitus

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概要

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• We describe a case of minimal nephrotic syndrome (MCNS) which was possibly induced by troglitazone administration in non-insulin dependent diabetes mellitus (NIDDM). A 68-year-old female patient with NIDDM had been poorly treated with gliclazide (40mg/day) for last four years when HbA1c levels were ranged from 7.0 to 8.2%, whereas such complications as diabetic retinopathy and overt nephropathy were not associated and serum CPR levels were preserved. In order to reduce insulin resistance, troglitazone, a new hypoglycemic agent, was started in a dose of 200mg b. i. d. However, she noticed edematous swelling in her lower extremities after two weeks and severe albuminuria (6.2g/day) developed after one month, which was persisted for the following 6 weeks although she had no previous history of proteinuria or hematuria. She was then admitted to our hospital and diagnosed by renal biopsy as MCNS associated with early-stage diabetic nephropathy. She was treated with prednisolone in combination with intensive insulin therapy. Her nephrotic state was rapidly improved. Recurrence of albuminuria was not recognized after taping off of prednisolone. These findings suggest that MCNS might be induced by troglitazone in a patient with NIDDM under the longer-term treatment with gliclazide.

• 島根大学の論文

著者

• YAMAMOTO Hiroyuki

  First Department of Internal Medicine, Sapporo Medical University

• Kato Y

  Department Of Endocrinology Metabolism And Hematological Oncology School Of Medicine Shimane Univers

• Kato Yuzuru

  島根大学 医学部内分泌代謝・血液腫瘍内科

• Kato Yuzuru

  島根大学 医学部内分泌代謝･血液腫瘍内科

• Kato Yuzuru

  First Division Department Of Medicine Shimane Medical University

• Shimizu T

  Department Of Endocrinology Metabolism And Hematological Oncology School Of Medicine Shimane Univers

• Nishiki Masateru

  First Division, Department of Medicine, Shimane Medical University

• Suzuki Takashi

  First Division Department Of Medicine Shimane Medical University

• Kurioka Soichi

  First Division Department Of Medicine Shimane Medical University

• Shimizu Tadashi

  First Division, Department of Medicine, Shimane Medical University

• Nishiki Masateru

  First Division Department Of Medicine Shimane Medical University

• Nishiki Masateru

  First Department Of Internal Medicine Shimane University Faculty Of Medicine

• Yamamoto Hiroyuki

  First Department Of Internal Medicine Sapporo Medical University

• Yamamoto Hiroyuki

  Department Of Pharmacology Wakayama Medical University

• Yamamoto Hiroyuki

  Department Of Microbiology St. Marianna University School Of Medicine

• Kato Yuzuru

  First Division Department Of Medicine Shiman Medical University

• Yamamoto H

  First Department Of Internal Medicine Sapporo Medical University

• Yamamoto Hiroyuki

  First Department Of Internal Medicine Department Of Radiology Sapporo Medical University School Of M

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