Familial clustering of diabetic kidney disease: evidence for genetic susceptibility to diabetic nephropathy

Article Abstract:

Destructive changes in the kidney (diabetic nephropathy) occur in less than 50% of all patients with diabetes. This study examines the role heredity may play in these changes to the kidney. The experimental design classified each presenter (proband) of diabetes into groups which either did or did not demonstrate nephropathy Siblings of each presenter are also examined both for the presence of diabetes and for diabetic nephropathy. All patients in the set with diabetic nephropathy had undergone kidney transplantation (were severely affected). The incidence of diabetic nephropathy in the relatives of the proband set which did not display kidney changes was 17 percent; the incidence in the set of affected probands was 83 percent. Statistical analysis found that the occurrence of kidney pathology in the proband was the only significant predictive factor in determining the risk to diabetic siblings. The authors conclude that diabetic kidney nephropathy occurs in familial clusters, and that heredity helps to determine susceptibility to such pathologies. The authors warn, however, that possible influences of environmental factors shared by siblings could not be ruled out.

Analysis, Diabetes, Diabetes mellitus, Health risk assessment

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Hodgkin's disease - environmental or genetic?

Article Abstract:

The basis of familial susceptibility to Hodgkin's disease may have been uncovered by a recent study of twins with the disease. The study analyzed the incidence of malignant lymphomas in a group of twins and compared the rate of coincidental Hodgkin's disease among identical and fraternal twin pairs. The results, based on slide reviews and polymerase chain reaction (PCR) evaluation for evidence of the Epstein-Barr virus (EBV), found that none of 187 pairs of fraternal twins had Hodgkin's disease, but 10 of 179 pairs of idential twins did. Most of the identical twin pairs with Hodgkin's disease had similar histologic subtypes and the nodular sclerosis form of Hodgkin's, both of which point to a genetic, rather than environmental, basis for susceptibility. Genetic susceptibility may be specific to Hodgkin's disease for a subgroup of patients, since other cancers occurred in identical twins only twice as often as in fraternal twin pairs. Environmental influences, such as viral infection, may cause a secondary transformation that causes Hodgkin's disease to occur in genetically susceptible persons.

Editorial, Hodgkin's disease, Causes of, Disease susceptibility

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A 59-year-old diabetic man with acute renal failure and a pulmonary infiltrate

Article Abstract:

A 59-year-old man was diagnosed with glomerulonephritis complicating diabetic kidney disease. Glomerulonephritis is an inflammation of the kidney. He had a 17-year history of adult-onset diabetes. He was admitted to a hospital with cough, fever and a lung mass on X-ray. Two months before admission, a medical examination revealed that he had protein in his urine, which is a sign of early kidney damage. During his hospitalization for possible pneumonia, he produced very little urine even though he was on diuretics. His lung infection responded to antibiotics. A kidney biopsy revealed that he had glomerulonephritis, probably caused by the bacterium that caused his pneumonia. Antibodies against streptococcal proteins were found in his blood. His kidney disease responded to treatment with corticosteroids.

Complications and side effects, Pneumonia, Glomerulonephritis

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