CASE OF A DIABETIC WITH A KIMMELSTIEL-WILSON SYNDROME AND A NORMAL GLUCOSE TOLERANCE

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Abstract
This ''is a case report of a well documented male diabetic, who, 12 years after the onset of his disease, developed manifestations of a Kimmelstiel-Wilson syndrome with retinopathy and proteinuria. A study of this patient revealed definitive evidence of classic diabetic nephropathy on renal biopsy. This was characterized by the presence of nodular hyaline masses in the glomeruli with marked capsular fibrosis. The retinopathic picture was characteristic of diabetic retinopathy with evidence of hard exudates and microaneurysms. In the face of this picture, a study of the patient''s carbohydrate tolerance revealed practically a normal capacity to handle carbohydrate. Glucose tolerance tests done both orally and by the intravenous route gave a completely normal curve and the patient could not be identified as diabetic until a cortisone stress test was performed by the technique of Conn and Fajans.