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Rare diagnosis in a patient with diabetes with nephrotic proteinuria
  1. Ariana Azevedo,
  2. Patrícia Cotovio,
  3. Mário Góis and
  4. Fernando Nolasco
  1. Nephrology Department, Centro Hospitalar de Lisboa Central, Lisboa, Portugal
  1. Correspondence to Dr Ariana Azevedo, ariana.cerqueira.azevedo{at}


We report a 63-year-old man with well-controlled type 2 diabetes mellitus and hypertension, who presented with new onset nephrotic proteinuria and rapid deterioration in renal function. The atypical clinical presentation prompted us to consider a non-diabetic and non-hypertensive cause and to perform a renal biopsy. A diagnosis of fibrillarglomerulonephritis (FGn) was made based on electronic microscopy. Proteinuria remained in nephrotic range despite treatment with prednisolone, and renal function deteriorated. We suggest that other causes of proteinuria should be considered in patients with diabetes who present with the nephrotic syndrome when there is no other evidence of microvascular disease. We review the spectrum of fibrillar glomerulopathies including FGn, primary and secondary amyloidosis and immunotactoid glomerulonephritis.

  • proteinurea
  • renal intervention

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  • Contributors AA contributed in writing and intellectual input. PC treated the patient and reviewed the article. MG contributed in analysis, data interpretation and reviewed the article. FN reviewed the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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