中年男性,以持续肉眼血尿伴大量蛋白尿、肾功能减退、血抗肾小球基膜( GBM)抗体阳性起病；肾活检组织学符合新月体肾炎,免疫荧光见IgG沿肾小球毛细血管袢线性沉积,符合抗GBM肾炎,同时亦见肾小球呈结节样改变、肾小管基膜(TBM)增厚、动脉透明变性等,超微结构观察GBM呈均匀一致性增厚,经糖耐量检查确诊糖尿病.该患者最终诊断为抗GBM肾炎合并糖尿病肾病(DN).%A 47-year-old man presented with gross hematuria.proteinuria and progressive renal dysfunction for more than 1 month. His serum anti-GBM antibody was positive. Renal biopsy showed glomerular crescent formation with linear distribution of IgG along GBM. In addition,there were glomerular nodular lesions like Kimmelstiel-Wilson nodules, diffuse thickness of tubular basement membrane and arterial hyalinosis. Ulrastructral examination indicated uniform thickness of GBM. Abnormal OGTT suggested diabetes mellitus. The final diagnosis of anti-GBM glomerulonephritis associated with diabetic nephropathy was made.
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