Paraneoplastic immunoglobulin A nephropathy and associated focal segmental glomerulosclerosis in asymptomatic low volume B-cell lymphoma - a case report.
BMC Nephrol
; 19(1): 224, 2018 09 10.
Article
em En
| MEDLINE
| ID: mdl-30200898
ABSTRACT
BACKGROUND:
Paraneoplastic glomerulonephritis is rare in haematological malignancies and tends to manifest as minimal change disease, membranous glomerulonephritis or membranoproliferative glomerulonephritis. We present the first report of immunoglobulin A nephropathy and associated focal segmental glomerulosclerosis in a patient with asymptomatic low grade B-cell lymphoma. CASE PRESENTATION A 53 year old gentleman presented with nephrotic range proteinuria (urine protein creatinine ratio of 662 mg/mmol) on a background of type 2 diabetes mellitus (glycosylated haemoglobin < 6%), hypertension, obesity (body mass index 47.6 kg/m2) and degenerative spine disease. Bone marrow biopsy diagnosed a low grade B-cell lymphoma and renal biopsy was consistent with immunoglobulin A nephropathy. Lymphoma treatment with six cycles of cyclophosphamide/ rituximab/ prednisolone led to normalisation of urinary protein excretion (urine protein creatinine ratio 14 mg/mmol at 26 months post-chemotherapy).CONCLUSION:
Paraneoplastic immunoglobulin A nephropathy can occur with a broad range of haematological malignancies regardless of stage. This case illustrates the importance of meticulous haematological system work-up for patients presenting with immunoglobulin A nephropathy. Recognition of paraneoplastic immunoglobulin A nephropathy and early diagnosis of associated malignancy can be life-saving.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Glomerulosclerose Segmentar e Focal
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Linfoma de Células B
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Doenças Assintomáticas
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Glomerulonefrite por IGA
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article