Occurrence of late specific complications in type II (non-insulin-dependent) diabetes mellitus.

The objective of the present study was to determine the occurrence of late specific complications, i.e., nephropathy, retinopathy, and autonomic neuropathy, in type II (non-insulin-dependent) diabetic subjects with a recent onset and with a disease duration of at least 5 years. The study design comprised of a population-based controlled cross-sectional survey of middle-aged type II diabetic subjects in the City of Tampere, Southwest Finland. The mean (SD) albumin excretion rate per 24 h was found to have increased in recently diagnosed diabetic subjects, i.e., 54 (111) mg (p < 0.0001), and in long-term diabetic subjects, 134 (479) mg (p < 0.0001), compared to nondiabetic controls, 16 (19) mg. Microalbuminuria (30 mg/24 h < or = albumin excretion rate < or = 300 mg/24 h) was detected in 8% of nondiabetic subjects and in 29% of recently diagnosed subjects and 27% of long-term diabetic subjects. The prevalence of clinical nephropathy (albumin excretion rate > 300 mg/24 h) was 7% in long-term and 4% in recently diagnosed diabetic subjects and zero in nondiabetic subjects. The differences between diabetic and nondiabetic subjects tested for microalbuminuria and clinical nephropathy were significant (p = 0.02-0.0001) exempting the difference between recently diagnosed female diabetic subjects and nondiabetic female subjects tested for clinical nephropathy. Seventy-five percent of biopsied diabetic subjects with an albumin excretion rate exceeding 100 mg/24 h were found to have diabetic glomerulosclerosis, while the rest had a normal finding. In long-term diabetic subjects the prevalence of nonspecific, background and proliferative retinopathies were present in 40%, 31%, and 8%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Secondary retinitis pigmentosa and cerebral demyelination in Lyme borreliosis.

A 15-year-old girl developed retinitis pigmentosa-like fundus changes in the left eye and optic neuropathy in the right eye as well as cerebral demyelination as a result of late Lyme borreliosis (LB). The diagnosis was confirmed by polymerase chain reaction, which detected a Borrelia burgdorferi specific segment of a gene coding for 41 kD endoflagellin, both in the vitreous and the cerebrospinal fluid. The diagnosis was delayed because testing for Borrelia antibodies in serum and cerebrospinal fluid yielded negative results. However, later on, another laboratory reported the antibodies of the patient's pretreatment serum to be positive for LB.