Cryoglobulinemic membranoproliferative glomerulonephritis type 1 in a patient with lymphoma: a case report and literature review
Article Sidebar
Main Article Content
Abstract
Acute kidney injury (AKI) is a common complication in malignant lymphoma. The causes of AKI are variable including hypovolemia, obstructive uropathy, and renal infiltration by lymphoma. Lymphoma associated glomerulopathy is less common, but important clinical features. Renal biopsy in AKI of unknown etiology in lymphoma patient is crucial for definite diagnosis and prompt management. Herein, we report a 52-years-old woman who had been diagnosed diffuse large B cell lymphoma, presented with AKI. She had no evidence of recurrent lymphoma from CT chest and whole abdomen. The renal biopsy was done because she had microscopic hematuria and proteinuria. The pathology showed cryoglobulinemic membranoproliferative glomerulonephritis type I which resulted from deposition of abnormal monoclonal immunoglobulin produced by malignant B cell. This finding is rare in malignant lymphoma, and here we also reviewed literature regarding this condition.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
This article is published under CC BY-NC-ND 4.0 license, which allows for non-commercial reuse of the published paper as long as the published paper is fully attributed. Anyone can share (copy and redistribute) the material in any medium or format without having to ask permission from the author or the Nephrology Society of Thailand.
References
Luciano RL, Brewster UC. Kidney involvement in leukemia and lymphoma. Adv Chronic Kidney Dis. 2014;21(1):27-35.
Christiansen CF, Johansen MB, Langeberg WJ, Fryzek JP, Sørensen HT. Incidence of acute kidney injury in cancer patients: a Danish population-based cohort study. Eur J Intern Med. 2011;22(4):399-406.
Khalil MA, Latif H, Rehman A, Kashif WU, Awan S, Khalil Z, et al. Acute kidney injury in lymphoma: a single centre experience. Int J Nephrol. 2014;272961.
Obrador GT, Price B, O'Meara Y, Salant DJ. Acute renal failure due to lymphomatous infiltration of the kidneys. J Am Soc Nephrol. 1997;8(8):1348-54.
Richmond J, Sherman RS, Diamond HD, Craver LF. Renal lesions associated with malignant lymphomas. Am J Med. 1962;32:184-207.
Corlu L, Rioux-Leclercq N, Ganard M, Decaux O, Houot R, Vigneau C. Renal Dysfunction in Patients With Direct Infiltration by B-Cell Lymphoma. Kidney Int Rep. 2019;4(5):688-97.
Cohen LJ, Rennke HG, Laubach JP, Humphreys BD. The spectrum of kidney involvement in lymphoma: a case report and review of the literature. Am J Kidney Dis. 2010; 56(6):1191-6.
Da'as N, Polliack A, Cohen Y, Amir G, Darmon D, Kleinman Y, et al. Kidney involvement and renal manifestations in non-Hodgkin's lymphoma and lymphocytic leukemia: a retrospective study in 700 patients. Eur J Haematol. 2001;67(3):158-64.
Li S-J, Chen H-P, Chen Y-H, Zhang L-h, Tu Y-M, Liu Z-h. Renal Involvement in Non-Hodgkin Lymphoma: Proven by Renal Biopsy. PLOS ONE. 2014;9(4):e95190.
Merlini G, Stone MJ. Dangerous small B-cell clones. Blood. 2006;108(8):2520-30.
Hogan JJ, Alexander MP, Leung N. Dysproteinemia and the Kidney: Core Curriculum 2019. Am J Kidney Dis. 2019;74(6):822-36.
Hoshida Y, Xu JX, Fujita S, Nakamichi I, Ikeda J, Tomita Y, et al. Lymphoproliferative disorders in rheumatoid arthritis: clinicopathological analysis of 76 cases in relation to methotrexate medication. J Rheumatol. 2007;34(2):322-31.
Kurita D, Miyoshi H, Ichikawa A, Kato K, Imaizumi Y, Seki R, et al. Methotrexate-associated Lymphoproliferative Disorders in Patients With Rheumatoid Arthritis: Clinicopathologic Features and Prognostic Factors. Am J Sur Pathol. 2019;43(7):869-884.
Feehally J FJ, Tonelli M, Johnson JR. Comprehensive clinical nephrology. 6th edition. 6, editor. china: Elsevier Inc 2019.
Roccatello D, Saadoun D, Ramos-Casals M, Tzioufas AG, Fervenza FC, Cacoub P, et al. Cryoglobulinaemia. Nat Rev Dis Primers. 2018;4(1):11.
Sethi S, Zand L, Leung N, Smith RJ, Jevremonic D, Herrmann SS, et al. Membranoproliferative glomerulonephritis secondary to monoclonal gammopathy. Clin J Am Soc Nephrol. 2010;5(5):770-82.
Harel S, Mohr M, Jahn I, Aucouturier F, Galicier L, Asli B, et al. Clinico-biological characteristics and treatment of type I monoclonal cryoglobulinaemia: a study of 64 cases. Br J Haematol. 2015;168(5):671-8.
Sidana S, Tandon N, Dispenzieri A, Gertz MA, Buadi FK, Lacy MQ, et al. Clinical presentation and outcomes in light chain amyloidosis patients with non-evaluable serum free light chains. Leukemia. 2018;32(3):729-35.
Villa D, Connors JM, Sehn LH, Gascoyne RD, Savage KJ. Diffuse large B-cell lymphoma with involvement of the kidney: outcome and risk of central nervous system relapse. Haematologica. 2011;96(7):1002-7.
Zhang L-l, Cao X-X, Shen K-N, Han H-X, Zhang C-L, Qiu Y, et al. Clinical characteristics and treatment outcome of type I cryoglobulinemia in Chinese patients: a single-center study of 45 patients. Ann Hematol. 2020;99(8):1735-40.
Yoo C CY, Shim SI, Lee K. IgA Nephropathy Encountered in a Patient with Hodgkin Lymphoma. Korean J Nephrol. 2008;27(6):720-5.
Muchtar E, Magen H, Gertz MA. How I treat cryoglobulinemia. Blood. 2017;129(3):289-98.
Vos JM, Gustine J, Rennke HG, Hunter Z, Manning RJ, Dubeau TE, et al. Renal disease related to Waldenström macroglobulinaemia: incidence, pathology and clinical outcomes. Br J Haematol. 2016;175(4):623-30.
Kohn M, Karras A, Zaidan M, Bénière C, de Fréminville JB, Laribi K, et al. Lymphomas with kidney involvement: the French multicenter retrospective LyKID study. Leuk Lymphoma. 2020;61(4):887-95.