Idiopathic Membranous Glomerulonephritis Occurring With Diabetes Mellitus

Light and electron microscopic studies of the renal lesions of diabetes mellitus have been frequently described,^1-3 whereas results of immunofluorescent evaluations are rare. Burkholder,⁴ in six cases of diabetic glomerulosclerosis, has demonstrated that the hypereosinophilic glomerular exudates and coarsely fibrillar glomerular nodules contain γ-globulin and fix heterologous complement. The γ-globulin bound diffusely in a delicate membranous pattern in glomerular capillary walls does not, however, fix complement.

It has been previously recognized that a correlation exists between the presence of diabetic nephropathy and the duration of clinical diabetes.^5-7 The following case report describes a patient with a 20-year history of insulin-dependent diabetes mellitus and the nephrotic syndrome. Renal biopsy demonstrated the glomerular lesions of membranous glomerulonephritis. We reviewed the clinical features of the nephrotic syndrome as seen in diabetes mellitus and will discuss the importance of immunofluorescent studies in establishing the diagnosis.

Patient Summary  A 56-year-old