Abstractthis setting will not be diagnostically useful. In retrospective studies of non-insulin dependent diabetes melBackground. Several studies had suggested that nondiabetic renal disease (NDRD) was common among litus (NIDDM ) patients with renal involvement, from 12-81% of their renal lesions were non-diabetic renal non-insulin dependent diabetes mellitus (NIDDM ) patients with renal involvement. diseases (NDRD), with different spectrum of diseases identified in different series [4][5][6][7][8][9]. Such retrospective Methods. We prospectively studied the prevalence of NDRD among a Chinese NIDDM population. Renal studies are apparently biased and tend to selectively include patients with clinical presentations thought not biopsy specimens were evaluated with light-, immunohistological and electron-microscopy. The cohort in keeping with diabetic glomerulosclerosis. Also, for patients found to have NDRD, different predicting consisted of 51 patients who had NIDDM and proteinuria >1 g/24 h.factors have been identified in these series, including late age of onset of DM [4], absence of neuropathy Results. Patients with both isolated diabetic nephropathy (DN, n=34) and NDRD (n=17) had compar- [4,5], absence of retinopathy [4,5] and presence of other systemic diseases [4]. However, these factors able duration of DM, creatinine clearance, serum creatinine, albumin and glycosylated haemoglobin were found to have variable predictive values in different series. In a limited number of prospective studies levels, as well as incidences of retinopathy, neuropathy and hypertension. Significantly more patients with of NIDDM patients with renal involvement, from 23-39% of patients were found to have NDRD NDRD had microscopic haematuria (P=0.043) or non-nephrotic proteinuria (P=0.004). IgA nephro- [10][11][12]. However, only the absence of retinopathy and autonomic neuropathy were found to be useful pathy accounted for 59% of the NDRD identified. Conclusions. In this study, microscopic haematuria clinical markers [10]. Overall, it remains unclear whether one is to offer biopsy for all such patients, or and non-nephrotic proteinuria predicted the presence of NDRD among NIDDM patients presenting with should indeed reserve biopsy for those patients with atypical features associated with proteinuria, i.e. renal disease.sudden onset, haematuria, acute renal insufficiency, extra-renal manifestations, and absence of retinopathy Key words: microscopic haematuria; non-diabetic renal disease; non-insulin dependent diabetes mellitus; non- [13]. We have performed a prospective study to clarify the issue in our local population where little data exist. nephrotic proteinuria Subjects and methods Patients
Although Kimura's disease has often been considered to be identical to angiolymphoid hyperplasia with eosinophilia (epithelioid haemangioma), recent studies suggest that they are different clinicopathological entities. In this study, we have made a detailed morphological comparison of 10 cases of epithelioid haemangioma and 40 cases of Kimura's disease occurring in the Chinese population. The epithelioid haemangiomas occurred in the subcutaneous tissue, skin and maxillary antrum, whereas Kimura's disease affected the subcutaneous tissue, major salivary glands and lymph nodes. Distinctive features of epithelioid haemangiomas were exuberant proliferation of vessels lined by cuboidal to hobnail endothelial cells with irregular nuclei and cytoplasmic vacuoles, fibromyxoid matrix, involvement of muscular coat of blood vessels and zonation of inflammatory infiltrate towards the peripheral portion of the lesion. Distinctive features of Kimura's disease were florid lymphoid infiltrate with prominent lymphoid follicles, vascularization of germinal centres, germinal centre necrosis, marked eosinophilia with or without eosinophil abscess formation, proliferation of high endothelial venules, and sclerosis. The histological features suggest that epithelioid haemangioma is a proliferation of atypical endothelial cells, possibly neoplastic, that is associated with a variable inflammatory infiltrate, whereas Kimura's disease is primarily an inflammatory condition in which high endothelial venules are usually found.
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