A case of misdiagnosis of diabetic nephropathy combined with IgA nephropathy presenting as rapidly progressive nephritis
At present,cases of diabetic nephropathy combined with IgA nephropathy presenting as rapidly progressive nephritis are rarely reported.In this paper,a case of a patient seen at Yidu Central Hospital of Weifang,Shandong Province,whose early manifestations were facial and bilateral lower limb edema,hematuria,proteinuria,and then urine output decreased and blood creatinine increased progressively.Diabetic nephropathy combined with anti-neutrophil cytoplasmic antibodies-negative vasculitis renal damage was diagnosed by combining clinical manifestations,light microscopy,and electron microscopy pathology results,and was treated with Methylprednisolone combined with Cyclophosphamide shock therapy.Because the patient had no vasculitis manifestations,immunofluorescence staining of paraffin sections was also performed,and a definite diagnosis of diabetic nephropathy combined with IgA nephropathy(crescentic type)was made.This paper analyzes the case report and related literature and finds that false-negative situations may occur in fresh tissue immunofluorescence during the diagnostic process,and such misdiagnosis can be avoided by minimizing false-negative results and improving the quality and reliability of immunofluorescence staining through appropriate antigenic repair methods.
IgA nephropathyRapidly progressive nephritisDiabetic nephropathy