Necrobiosis Lipoidica Diabeticorum in Children and Adolescents: A Clue for Underlying Renal and Retinal Disease

: The prevalence of persistent microalbumlnuria, retinopathy, and peripheral and autonomic neuropathy was assessed In 18 children and adolescents with type 1 (insulin-dependent) dlabetes mellitus (IDDM) who suffered from necrobiosls llpoldlca diabeticorum (NLD) and in 40 dlabetics without NLD, matched for sex, age, duration of disease, and metabolic control. The mean ± SD age ot the patients was 15.1 ± 8.6 years (range 7.9–23.9 yrs) and their duration of IDDM was 10.9 ± 8.1 years (range 7.1–21.0 yrs). Their mean glycosylated hemoglobin level was 9.9 ± 5.0% (7.3–16.6%) and their fructosamine level was 274 ± 180 μmol/L (199–466 μmol/L). Patients with NLD had a higher frequency of persistent microalbumlnuria (p < 0.001) and retlnopathy (p < 0.001) than those without NLD. Our study suggests that children as well as adult diabetics with NLD can be at high risk for nephropathy and retinopathy; NLD can be a clue for diabetic nephropathy and retinopathy.