細小血管障害性溶血性貧血を伴った糖尿病性腎症の1例

Abstract

A case of diabetic nephropathy with microangiopathic hemolytic anemia (MHA) is reported. The patient, a 61-year-old woman, had a 14-year history of non- insulin-dependent diabetes mellitus. On admission to our hospital on March 29, 1996, she had hypertension, proteinuria, and anemia. Results of laboratory tests showed proteinuria (3g/day), renal dysfunction (Ccr 46ml/min), and hemolytic anemia (hemoglobin concen- tration 7.9g/dl, reticulocyte count 63%, and indirect bilirubin 1.0mg/dl). Red cells were fragmented in peripheral blood smears. Therefore, a diagnosis of MHA was made. In addition, renal biopsy revealed diffuse diabetic glomerulosclerosis. After treatment with antihypertensive drugs, her blood pressure normalized and her anemia improved. Diabetic microangiopathy and hypertensive vascular injury may have caused MHA in this patient.