Diabetes mellitus associated with rapidly progressive glomerulonephritis with perinuclear antineutrophil cytoplasm antibodies

A 55-year-old woman who had been treated for diabetes mellitus for twenty-f ive years developed interstitial pneumonia and rapidly progressive glomerul onephritis (RPGN), The findings of light microscopy revealed fibrocellular crescent formation in all glomeruli and infiltration of lymphoid cells in i nterstitium. There were no deposits in the intracapillary area and mesangia l area on both immunofluorescence and electron microscopy, Her interstitial pneumonia improved with pulse therapy of methylprednisolone and her hematu ria disappeared with mix treatment of cyclophosphamide and double filtratio n plasmapheresis (DFPP). Her serum creatinine level improved from 2.2 mg/ d l to 1.5 mg/dl. Interstitial pneumonia and hematuria did not recur at twelv e months after the first hospitalization. This report presents a rare case with RPGN associated with diabetes mellitus who recovered with combination therapy of cyclophosphamide, steroid and DFPP.