Cryoglobulinemic Glomerulonephritis Associated With Nodal and Renal Infiltration by T-Cell Lymphoma of T-Follicular Helper Phenotype: A Case Report.
Am J Kidney Dis
; 72(4): 606-611, 2018 10.
Article
em En
| MEDLINE
| ID: mdl-29784613
ABSTRACT
We present a unique case of cryoglobulinemic glomerulonephritis associated with nodal and renal infiltration by T-cell lymphoma of T-follicular helper phenotype. The patient presented with transient neurologic symptoms, severe nephritic syndrome with nephrotic-range proteinuria, and acute kidney injury. He had elevated double-stranded DNA levels, low complement levels, detectable cryoglobulin, and detectable immunoglobulin M (IgM) paraprotein. The kidney biopsy showed cryoglobulinemic glomerulonephritis with a membranoproliferative pattern and diffuse interstitial infiltrates on light microscopy; IgM, C3 but weak IgG, C1q, and negative C4d staining on immunofluorescence; and deposits with organized substructures on electron microscopy. Positron emission tomography showed diffuse uptake in bilaterally enlarged kidneys and a localized group of lymph nodes. Subsequent lymph node biopsy revealed Epstein-Barr virus-negative nodal T-cell lymphoma, which was also proven in renal tissue. The association between T-cell lymphoma, autoantibodies, and cryoglobulinemia may represent a paraneoplastic phenomenon. His renal prognosis has been excellent, but overall prognosis and survival is dictated by the clinical course of T-cell lymphoma.
Palavras-chave
Mixed cryoglobulinemic glomerulonephritis; T-cell lymphoma; autoantibody; case report; follicular helper phenotype; hypocomplementemia; kidney biopsy; lymphoid neoplasm; lymphoproliferative infiltration; membranoproliferative glomerulonephritis (MPGN); nephrotic syndrome; paraneoplastic; renal infiltration
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Glomerulonefrite Membranoproliferativa
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Protocolos de Quimioterapia Combinada Antineoplásica
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Linfoma de Células T
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Linfócitos T Auxiliares-Indutores
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Crioglobulinemia
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Neoplasias Renais
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Humans
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Male
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article