Essential mixed cryoglobulinemic glomerulonephritis associated with diabetic glomerulosclerosis. Light, immunofluorescence, and ultrastructural study of two cases

Abstract

The association of cryoglobulinemic glomerulonephritis with diabetic glomerulosclerosis is reported in two patients. Renal pathology was investigated by light and electron microscopy and by immunofluorescence on biopsy material from both patients and on autopsy material (obtained a few hours after death) from one patient. Glomerular involvement due to cryoglobulins preceded the development of diabetic glomerulosclerosis in one patient. This contrasts with what has been reported in the literature, where various types of glomerular lesions are reported to be superimposed on overt and often long-lasting diabetic glomerulopathy. Though the association may be coincidental, the immune complexes (cryoglobulins) may have accelerated the formation of the nodular hyaline diabetic lesions in the mesangium through a mesangiolytic process.