A child of minimal change nephrotic syndrome with type 1 diabetes mellitus

概要

論文の詳細を見る
When he was 5 years old, he was diagnosed having type 1 diabetes mellitus and started insulin therapy. At 9 years old, he had stomachache, vomiting and edema, and severe proteinuria and hypoproteinemia were elucidated. His illness was diagnosed as nephrotic syndrome, and oral prednisolone (PSL) was administered. Subsequently his blood glucose level rose. We increased the number of times of the blood sugar determination and increased insulin. Two weeks later from the start of treatment, his proteinuria did not decrease. We administered cyclosporine (CyA) with steroid. Four weeks later from the start of treatment, his nephrotic syndrome completely remitted. During alternate―day PSL administration, the basic insulin doze was increased only on the day when he took PSL. HbA1c at one month later from the start of the treatment was 7.7%, and at two month later was 7.8%. Early induction of immunosuppressant and the adjustment of the insulin dose during PSL alternate―day administration enabled early reduction of steroid and stable blood glucose level.