To the Editor.
—We read with interest the case reports and review of idiopathic membranous glomerulopathy in diabetic patients recently published in the Archives (1980;140:624-627). All of the cases discussed membranous glomerulopathy occurring many years after the onset of diabetes mellitus. Such a temporal disassociation could be taken as evidence for pathogenetically unrelated concurrence of two not uncommon diseases.We would like to report a case in which membranous glomerulopathy and insulin-resistant diabetes mellitus occurred almost simultaneously. This concurrent onset of two possibly immune-mediated diseases suggests common pathogenesis.
Report of a Case.
—A previously healthy 25-year-old man in whom nephrotic syndrome (10 g/24 hr proteinuria) with microscopic hematuria developed underwent a renal biopsy five months after onset. By light microscopy, there was diffuse global capillary wall thickening, with only mild focal segmental mesangial hypercellularity. Immunofluorescence microscopy disclosed diffuse global granular capillary loop deposition of IgG, 3+; IgM, 1 +; IgA, 1